advance directive

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advance directive

a declaration by a person in relation to medical treatment (usually to instruct that it stop) to provide for a situation in which he might himself be unable to comment, e.g. the so-called living will. The US Supreme Court established the right for a person to refuse medical treatment, which in the case of a comatose patient can be difficult to establish. This is an issue that is troubling most legal systems because it raises moral, philosophical and practical questions. In the UK the directive is legally effective because treatment requires consent. It need not be in writing. It cannot, however, compel doctors to cease treatment so as to mercy-kill or provide treatment which they do not consider to be in the best interests of the patient.
References in periodicals archive ?
"The issue was about where the documentation was in the notes and the doctors and nurses who were treating the patient at the time, and indeed the family, were unaware that the patient had made an advanced directive stating what their wishes were," she said.
"Initiating an advanced directive can create a great communication with your spouse or your significant other or your family.
Most Americans do not have an advanced directive nor do they get around to having that all--important conversation with loved ones.
As the one responsible for continuity of a patient's care, the family physician is the appropriate person to counsel patients about advanced directives. These decisions are neither simple nor static.
An advanced directive is a way to tell your family and doctor your wishes if you cannot make decisions yourself.
That person had for all intents and purposes died when she was admitted to the hospital." If the patient who executed the advanced directive is "dead," then our next question should be, Who is the person here now?
A random survey of 50 patient charts at McKenzie-Willamette every six months found 22 percent of patients had filled out an advanced directive.
But the fact is, many nurses do not have advanced directives for themselves and their family members.
It is neither ethically right nor legally lawful to apply an advance directives document (2) whilst a patient enjoys sufficient competence to make autonomous decisions and express his or her informed consent (1); nor is it to request a decision from a patient's proxy (3) whilst the former maintains his or her capacity to make autonomous decisions (1) or has previously let his or her wishes be known in the form of an advanced directives (2).
Formal interviews were audio-recorded, transcribed verbatim and analyzed into themes describing content with regard to the participants' clinical experiences with use of advanced directives in ICU and recommendations for improving advanced care planning for ICU patients.
The overall themes are perspectives of international and European law on dignity and self-determination at the end of life; advanced directives, end-of-life decision-making; and euthanasia in comparative legal perspective; and the ongoing debate on advance directions regulation in Italy.
They did not indicate the amount of end-of-life discussion devoted to advanced directives.

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