The AMD (Advanced Medical Directive) is a ticking time bomb for WTC. Since they print it and provide direction for compliant use, they take on liability for future litigation from disgruntled family members who will charge that WTC coerced their loved one to refuse life-saving medical treatment.
That is why DF'd and inactive ones are not given the card - they can only craft their own using the same wording. WTC knows that DF'd persons are more likely to sue when things go wrong. This tells me that they are well aware that the AMD could bite them hard in the future. I am surprised that they still print and distribute it given the risk.