the physician's perspective physician gave their own ethical principals priority. The reverse may also be true: Despite an advance directive requesting that treatment be provided, physicians may judge that treatment would be of little benefit to the client in the given circumstances and unilaterally decide to withhold or withdraw treatment. (p. 93) Why are Advanced Directives not Followed Fear of litigation is another factor. Added to the moral, ethical and humane considerations, physicians also must keep the legal risks in mind. No group is more subject to the risks of litigation than the medical profession. The medical professional does not want to be accused of pressuring the family for removal of life support, or to be second guessed by other medical personnel in a court of law. Even when advance directives that would seem to protect the physician are executed, relieving the physician of some liability, physicians may not comply with their patient's wishes (Hoefler, p. 93). Uncertainty about the meaning and application of a directive is another reason for not implementing an advance directive once it has been found and examined. The law on honoring advance directives from one state to another is unclear. "Actually the forms are not significant legal documents in and of themselves" (Purtilo, 1995, p. 132-133). "Even a signed living will could be disqualified if it failed the court's measure for being not recent enough, not logically consistent, or not specific enough" (Lynn). Interpreting advance directives can be problematic at times, as when information is lacking, or when a strict reading of the document does not seem to make sense. For example, the advance directive may suggest one course of care, while the physician and/or family believe the patient would in fact have wanted something else. No advance directive can ...
