Which factor is not required to activate an advance directive?

Which factor is not required to activate an advance directive?

• A. Documentation in the medical record
• B. Discussion with patient or surrogate
• C. Physician involvement
• D. Automatic activation when admitted without patient input

Answer: (D)

Activation of an advance directive hinges on the patient’s expressed wishes being known and accessible, not on automatic events at admission. A valid directive must be documented in the medical record so the care team can find and follow it, and there should be a discussion with the patient or a surrogate to confirm that the directive still reflects the patient’s current preferences. While clinicians are the ones who implement the directive in care, activation does not require a clinician to initiate it at the moment; it relies on the directive being on file and aligned with the patient’s wishes. Automatic activation simply upon admission without any patient input does not occur.

Activation of an advance directive hinges on the patient’s expressed wishes being known and accessible, not on automatic events at admission. A valid directive must be documented in the medical record so the care team can find and follow it, and there should be a discussion with the patient or a surrogate to confirm that the directive still reflects the patient’s current preferences. While clinicians are the ones who implement the directive in care, activation does not require a clinician to initiate it at the moment; it relies on the directive being on file and aligned with the patient’s wishes. Automatic activation simply upon admission without any patient input does not occur.