Definition of the problem <p>Advance directives encounter various obstacles in clinical practice that affect their legal validity.</p> Arguments <p>One aspect that has so far received little attention in the national context is the willingness of physicians to implement advance directives. The study focusses on the (non-)adherence of physicians with regard to advance directives. An interview study based on case vignettes was conducted with 17&#xa0;physicians from different disciplines.</p> Conclusion <p>The results indicate that various factors (including orientation towards the patient’s wishes or the interpretation of professional ethics) can influence the decision in favor of or against the implementation of advance directives. The results are also discussed against the background of the interplay between indication and patient wishes.</p>