As a reminder, you should provide copies of your completed Advance Decision document to (1) those who served as witnesses, (2) your General Practitioner (doctor), and (3) your congregation secretary.
This is coercion. Someone saying no to this instruction (not giving a copy of his ADD to the secretary), will be deemed week/not in good standing. Sure its not written word for word in the letter, but we know full well that this is what it is. Hence, privileges such as holding the mic, pioneering or saying prayers will be withheld. Eventually, with enough pressure, they will find that brother or sister at fault for other things and form a JC. While, all along, everything started with the brother not making a copy of his ADD.
You may believe that filling out the ADD, sending them copies and then, going to a lawyer and doctors to give them different sets of instruction will get you out of this gem. Well. No. The photocopy of your instructions will allow them to speak for you. At one point or another, the doctors will have to tell them that they do not have that right as the patient has signed other directives that override the photocopies you elders have. When that happens, you'll wake up and find yourself disfellowshiped. There is also the other scenario where your legal representatives are not even around in the hospital you land in. However, JWs manage to send in HLC elders with your photocopies in and then, you die for lack of blood.