Which action best supports honoring a patient’s end-of-life wishes as expressed in an advance directive?

• A. Follow the directive if valid, and communicate the patient's preferences to the healthcare team.
• B. Ignore the directive if family disagrees.
• C. Modify the directive based on staff convenience.
• D. Share directives only with the primary physician.

Answer: (A)

Respecting patient autonomy through an advance directive means following the patient’s stated wishes when the directive is valid and applicable. If a patient has clearly expressed preferences about end-of-life care in an advance directive, those instructions guide the medical team, even if family members disagree. To implement this, verify that the directive is current and legally valid, ensure the patient had capacity when it was created, and make the directive accessible to all members of the care team so everyone knows the patient’s preferences. This approach protects the patient’s rights, helps prevent unwanted interventions, and provides consistency of care across providers and transitions. If questions arise about applicability or conflicts with surrogates, seek ethics or legal guidance and involve the appropriate decision-maker, rather than altering or disregarding the directive. The other options fail because they undermine the patient’s previously stated wishes and the ethical obligation to honor autonomy.