Book contents
- Frontmatter
- Contents
- Acknowledgments
- 1 Introduction
- 2 A case for the legalisation of voluntary medically assisted death
- 3 Medical futility
- 4 Physician-assisted suicide
- 5 The sanctity of human life
- 6 Killing versus letting die, the doctrine of double effect, and palliative care for the dying
- 7 Professional integrity and voluntary medically assisted death
- 8 Competence and end-of-life decision making
- 9 Advance directives
- 10 Voluntary medically assisted death and slippery slope arguments
- 11 Non-voluntary euthanasia
- 12 Concluding remarks
- References
- Index of English-language legal cases
- Index of names and subjects
9 - Advance directives
Published online by Cambridge University Press: 05 June 2012
- Frontmatter
- Contents
- Acknowledgments
- 1 Introduction
- 2 A case for the legalisation of voluntary medically assisted death
- 3 Medical futility
- 4 Physician-assisted suicide
- 5 The sanctity of human life
- 6 Killing versus letting die, the doctrine of double effect, and palliative care for the dying
- 7 Professional integrity and voluntary medically assisted death
- 8 Competence and end-of-life decision making
- 9 Advance directives
- 10 Voluntary medically assisted death and slippery slope arguments
- 11 Non-voluntary euthanasia
- 12 Concluding remarks
- References
- Index of English-language legal cases
- Index of names and subjects
Summary
To this point my focus has largely been on the permissibility of competent dying patients choosing the manner and timing of their death, including, where necessary, with medical assistance. However, it is a fact of life for many patients that by the time death looms they are no longer competent and so are unable to make autonomous decisions. For these dying patients, it is, therefore, of great significance whether reliance can be placed on end-of-life choices made while they were competent. In particular, it is of great significance whether careful, written specifications of those choices (in the form of advance directives, or what are sometimes called ‘living wills’) should be accorded a privileged status as conveying competently formed convictions that are to bind their end-of-life treatment.
To decide these matters it will be necessary to consider whether the ‘prior consent’ recorded in an advance directive can be considered authentic given the impossibility of confirming or ratifying it once competence is lost. (When a patient remains competent, and so is able to confirm the instructions in his advance directive, this issue will not arise. No competent individual can be bound by what he earlier decided, so a competent individual can simply overturn an advance directive if he undergoes a change of mind. Not to allow him to change his mind would itself be a serious infringement of his autonomy.)
- Type
- Chapter
- Information
- Medically Assisted Death , pp. 155 - 177Publisher: Cambridge University PressPrint publication year: 2007