eTable 1. Overview of important documents.
| Document | Purpose | Important points | Example |
| Health care proxy (HCP) | Who should speak for the patient when the patient can no longer speak for himself or herself? | – The HCP should remain valid after death; only in this way can, for example, a mobile-telephone contract be canceled after the patient is deceased. – Appointing multiple persons as health care proxies of equal status may lead to blocked decision-making in case these persons are of diverse opinions on what should be done. – Another person should always be named as a replacement in case the designated person cannot serve. – One can state, for the case that a legal guardian is needed, who should be named and/or who must not be named for this purpose. Doing so can obviate the need for a care directive. – If there is no person in a position of trust with the patient who can be named for this purpose, the appointment of a guardian by the court offers the advantage of additional legal protection. |
example downloadable at (20, 21) |
| Advance health care directive (AHCD) | establishes preferences for situations that may arise in which the patient can no longer make decisions or express wishes (21) | – responsibility of the physician: speak in detail with the patient about what situations can be expected over the further course of the illness – establish treatment preferences for each of these situations – as it is impossible to cover all potential situations, the AHCD can be supplemented by brief case illustrations or a statement by the patient of his/her fundamental attitudes toward life and death (eBox 21). |
example downloadable at (22) |
| Emergency directive (ED) | enables physicians to make rapid decisions in the patient’s best interest in case of unexpected acute events | – can stand alone or as a supplement to an AHCD – an ED is important, e.g., when health care proxies cannot come to the hospital in time or when acute triage decisions must be made, e.g., during the coronavirus pandemic |
(23) (24) |
| PALMA (patient directive for life-sustaining measures) | a supplement to the AHCD for patients in palliative care with limited time left to live | – supplement to an AHCD – must be made in cooperation with a physician and must be co-signed by the physician |
downloadable at (25) |
| Care directive | states who should and should not be called on to care for the patient | – establishes the patient’s wishes for what should be done for him or her during care | example downloadable at (26) |
| Custody directive | states who should take care of the children after the parents’ death | – A guardian can be named. – It can be stated who should definitely not be granted custody. In case of death, the matter will be considered by the family court. – Personal custody and property guardianship can be separated. |
(e8, e9) |
| Spiritual advance directive | provides help in decision-making in cases of severe illness or moribund state; enables dealing with spiritual topics | – gives an impression of the patient’s values, convictions, and sense of the meaning of life. – Patients often want to talk with a physician; this can lead to a better quality of life, to reduced depression, and to an improved physician-patient relationship (e10; e11) |
example downloadable at (e12) |
| Putting together important data, facts, and access codes | enables the family to find all of the impor‧tant information | – assemble all of the important information | inheritance checklist |