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Making advance directives meaningful.

N L Cantor1

  • 1Rutgers Law School, 15 Washington Street, Newark, New Jersey 07102, USA.

Psychology, Public Policy, and Law : an Official Law Review of the University of Arizona College of Law and the University of Miami School of Law
|June 14, 2003
PubMed
Summary

Carefully drafted advance directives, focusing on patient values and intolerable indignity, can be effective tools for end-of-life care. This approach enhances the practicality and meaningfulness of these important legal documents.

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Area of Science:

  • Bioethics
  • Medical Law
  • Palliative Care

Background:

  • Advance directives are often criticized for being impractical or ineffective in end-of-life care.
  • Existing criticism rarely distinguishes between the diverse types of advance directives available.

Purpose of the Study:

  • To argue that carefully drafted advance directives can be effective tools for end-of-life decision-making.
  • To identify the shortcomings of current advance directive documents and propose improvements.

Main Methods:

  • Analysis of existing advance directive forms and their approaches to defining intolerable indignity.
  • Examination of common elements of indignity that trouble dying patients.
  • Proposal of a unique values profile to help individuals articulate their end-of-life preferences.
Keywords:
Death and Euthanasia

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Main Results:

  • The inadequacy of current advance directives stems partly from vague and uninformative documentation.
  • Patients preparing advance directives aim to define a threshold of intolerable indignity.
  • A values profile approach can help individuals articulate an "intolerably deteriorated status".

Conclusions:

  • Well-crafted advance directives, focusing on specific elements of indignity and patient values, can be effective.
  • A values profile offers a more relevant and meaningful way for individuals to express end-of-life preferences.
  • Improving advance directive documents enhances their utility in end-of-life care planning.