When may an advance directive be changed?

• A. Yes, at any time
• B. No, only with physician approval
• C. Only during hospitalization
• D. Only when the patient is competent

Answer: (A)

An advance directive can be changed whenever the person has decision‑making capacity. This reflects a patient’s ongoing autonomy: their current wishes should govern care, so they may revoke or revise the directive and have a new directive take effect. The change does not require physician approval, and it isn’t limited to hospitalization. If the person is competent, they can alter or revoke the directive at any time and the most recently expressed wishes should be followed. If capacity is lost, changes aren’t made by the patient; instead, decisions follow the existing directive or appoint a surrogate to implement those wishes under applicable law.