2. For instance, I had taken care of a diabetic patient when I was a nursing student. She had received the right toes amputation operation once because her high blood sugar made these toes gangrenous and necrotic. She didn't have the good blood sugar control. Unfortunately, her new wound got the virus infection and gangrene again. Therefore the doctor decided to perform the second amputation operation from the right leg ankle to knee joint.

3. Before she underwent the operation , she very expected her disease was under control. by medical treatment - Whereas, after the second amputation, she had became upset and sad because the body image was changed and her condition was getting progressively worse. Final1y, she lost confidence. She worried about the enormous medical bills' burden to her family.

4. After two months, she received the third amputation from the right knee joint to upper thigh because the virus infection were still out of control. In addition, the wound tissues were getting necrotic, intensive pain, and had an odd smell from the wound continually. She was disappointment and depress completeJy because she knew that her disease was incurable. Beside, she understood that she was going to die in the severe infection sooner or later. It was impossible to perform the amputation again.

5. Finally, she asked to sign a form refuse medical treatment. After a few days, her life was terminative. In my view, if we make a right health care decision with the advance directive, that will decrease the family burden and would alleviated the intense pain in our terminal stage.