[The importance of the advance directive and the difficulties of its prevalence].

The Advance Directive (A.D.) is not prevalent enough in Japan. Under such a situation, it is difficult to withhold and withdraw the life-prolonging treatment. Even among the medical and care specialists, A.D. is not well known yet. From the result of the questionnaires, only 2% of the responders (who work for nursing care) know the exact meaning of A.D. But after the lecture about A.D., 96% of the responders recognized the importance of A.D. Through the experience of making A.D., it is useful not only to respect the patient's Autonomy, but also to be a communication tool among the patients, family and medical specialists.