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Background In emergency situations, the challenge arises of determining which treatment plan best meets the needs of the patient. Should interventions or life-sustaining and intensive care measures be performed or not? In these moments, statements in advance directives play a crucial role in guiding the decision-making process. However, non-specific advance directives that include options based on speculative prognosis can sometimes become ineffective when it comes to implementing the treatment plan.Main Text In emergency situations, treatment decisions should align with the patient‘s best interests. The presence of an advance directive is particularly useful when it provides clear guidance on whether individuals want all possible life-sustaining measures or wish to forgo them entirely. A challenge arises when individuals want life-sustaining measures, provided that there is a chance of returning to their prior quality of life. Prognoses are often uncertain at the outset, and intensive medical treatment, potentially with organ-supportive devices, may be necessary to assess therapy responses and make a more accurate prognosis.In addition intensive care treatments should not only be seen in the context of life preservation; they are also performed for a variety of other reasons, ranging from basic monitoring to the management of delirium, which cannot always be addressed in standard wards due to logistical constraints. These measures may conflict with a patient’s wish to avoid intensive care.Therefore, thorough and clear counseling in advance care planning is necessary to raise awareness of treatment options and the potential need for monitoring and intensive care interventions.Unique Contribution This session will offer insight into the practical application of advance directives and the challenges involved in treatment planning, presented by an experienced intensive care physician, emergency doctor, and ethicist. Case studies and personal experiences will be shared to provide a deeper understanding of the complex intersection between advance care planning and treatment decisions.Implications Advance directives should be respected. Understandable statements with derivable, feasible treatment options are essential to meet the needs of patients, relatives, and healthcare professionals. This stream aims to expand the communication of advance health planning, which is already complex in its current form but still does not provide completely comprehensive information to those receiving advice. The relevance of the site meeting to determine therapy goals is emphasized, and it is demonstrated that the treatment wishes documented in advance directives may have limitations in hypothetical situations.