INTRODUCTION

Living wills, also known as Advance Directives, allow an individual to participate in future decisions about his healthcare provision. The Advance Directive is written at a time when that individual is in ‘good’ mental and physical health, in anticipation of a future event that deprives him of his autonomy and decision making capacity.

THE ROLE AND SCOPE OF LIVING WILLS

Living wills may take the form of an instruction that specifies consent to lifesaving resuscitation and treatment, or one which specifies refusal of consent, which would lead to withdrawal or withholding of life saving treatment. In either case the instruction cannot amount to what would be directions for euthanasia, which remains illegal. Living wills are also quite distinct from and should not be confused with cases such as that of Diane Pretty which concern voluntary euthanasia or assisted suicide.

Prior discussions between an individual and his healthcare professional that form the basis of a living will, represent the exercise of ‘actual’ autonomy by that individual. However at the point at which the living will would be put into effect, the individual cannot participate and hence there is a lack of contemporaneous personal choice. The contemporaneous nature of any decision is a significant factor in deciding whether a living will should be followed or not, particularly when the patient's instructions would lead inevitably to his death.