59MDWI44-150 — Advance Directives And End-of-life

59MDWI44-150 governs advance directives and end-of-life medical treatment, including informed consent, patient choices, and do-not-resuscitate orders.

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  • Publication number: 59MDWI44-150
  • Title: ADVANCE DIRECTIVES AND END-OF-LIFE
  • Date: 2023-02-28

View 59MDWI44-150 on armypubs.army.mil


It establishes policies and procedures for advance directives, same-day surgery, and do-not-resuscitate orders in specified clinical settings. It requires staff to provide information, document patient decisions, and follow applicable Texas law.

Applies to: This instruction applies to all personnel assigned, attached, or on contract to the 59th Medical Wing (59 MDW) with the exception of the 959th Medical Group, Air National Guard, or Air Force Reserve.

Topics covered

  • Advance directives
  • End-of-life issues
  • Informed consent
  • Same-day surgery
  • Do-not-resuscitate orders
  • Patient treatment decisions

Questions and answers

What law does 59MDWI44-150 require 59 MDW to follow for advance directives?

The 59 MDW will comply with Texas law on ADs and the law regarding informed consent and the patient’s right to accept or refuse medical or surgical treatment. (paragraph 2)

Are advance directives from other states honored?

Honor ADs completed in other states, so long as the document appears valid (signed, dated, and witnessed). (paragraph 2)

What must the primary care manager discuss with a patient considering an advance directive?

The PCM will discuss with interested patients the information necessary for the patient to make an informed decision to either make or not make an AD. (paragraph 2)

What happens when a patient scheduled for same-day surgery has an advance directive that is not uploaded?

If the answer is yes and the AD is not yet uploaded in Genesis, the clinic will instruct the patient to bring a copy of their AD on the day of surgery. (paragraph 2)

Can surgery be ruled out solely because a patient has a do-not-resuscitate order?

Surgery should not be ruled out solely because a DNR order has been written. (paragraph 2)

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