When are advance directives used to guide medical decisions?

• A. Used when patient lacks capacity to decide; surrogate decisions guided by directives.
• B. Used only for minors.
• C. Used only when hospitalization occurs.
• D. Used to avoid any surrogate involvement.

Answer: (A)

Advance directives capture a patient’s treatment preferences to guide medical decisions when they can’t participate in the choices themselves. They come into play specifically when the patient lacks decision-making capacity due to illness, injury, or other impairment. In that situation, a surrogate or decision-maker should follow the directives to align care with the patient’s values and stated wishes. This is why the correct idea is that advance directives are used when the patient cannot decide, and the surrogate’s decisions are guided by those directives. They aren’t limited to minors, and they don’t remove the need for a surrogate entirely—rather, they inform and constrain what the surrogate and clinicians should do. They also apply across care settings, not just during hospitalization.