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Advance directives: a third option
1Division of Health-Care Ethics, The University of British Columbia, Canada.
Abstract:
As autonomy can only be exercised when a person is competent, advance directives give the potential to extend autonomy during incapacity. Most advance directives specify when intervention measures are not to be used. The elderly, or those with a fatal or chronic illness commonly give these directions. This type of advance directive does not satisfy he concerns of the younger and healthier segment of the population, and may be unsuitable for the older person. Healthy people are less concerned with procedures; they are concerned with outcome. All groups are concerned with certainty. These concerns may be better addressed by combining an instructional and a proxy directive, and for the healthy, by emphasizing ends rather than means. An example of such a directive is proposed.