[Advance directives and patient autonomy: Searching for an ethical perception]

The complexity of the discussion about the advance directive requires not only juridical, but most importantly ethical considerations. These are advanced in three steps in this article: a reflection about the changed perception of death and dying today after the anthropological and technological turn; a new understanding of the notion of autonomy as contextual, historical and communicative; autonomy as a process of learning. The discussion about the advance directive becomes thus a space for thinking about new forms of integrated care and a dignified death.