Jgim or Ig Inal Art Icles

A dvance directives indicate who a person would want to make treatment decisions on his or her behalf and what treatments a person would or would not want in various situations. 1,2 Completed by a person who can understand and appreciate the consequences of treatment decisions (i.e., when he or she is competent or capable), an advance directive is used at a time when the person has become incompetent or incapable. Current advance directive documents—for example, the Medical Directive, 3 Let Me Decide directive, 4 University of Toronto Centre for Bioethics Living Will, 5 Values History, 6,7 or the forms prepared by lawyers and governments—are all generic. Intended for the general public, generic advance directives can be criticized because they contain hypothetical, often irrelevant choices and inadequate prognostic information. Compared with generic advance directives, advanced directives designed specifically for people who have a particular disease have several potential advantages. 8 First, they present patients with choices that are more relevant than those contained in generic advance directives. Second, because the group of patients completing the advance directive document is more homogenous, more specific prognostic information can be presented. Finally, because the patient already has experience of the illness that may lead to those choices, the choices themselves are less hypothetical. Whether these theorized advantages of disease-specific advance directives are borne out in practice is currently unknown. The purpose of this study was to determine whether persons living with HIV find a disease-specific HIV advance directive more acceptable than a generic advance directive.