As part of the law we are obligated to ask concerning advanced directives. Only about 1/3 of patients admitted to the hospital have an advanced directive and only a small portion of those have them complete. Advanced directives from one state are not legal in another state. Now... a patient admitted has made it clear that they do not want any life sustaining medical intervention should the need arise. The patient has a turn for the worse and can no longer verbalize their desires. Someone in the family has told the attending MD that what is being recommended such as dialysis, feeding tubes etc. should be done. All this against the known patient wishes. The doc does not have the "BALLS" to tell the family that that is not the patient wishes and he/she is going to honor the wishes of the patient. The nurse is caught in the middle. Advance directives, Living Wills are not worth the paper they are written on until it is illegal to not honor a patient's wish.