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From advance directives to advance care planning: current legal status, ethical rationales and a new research agenda
Author(s) -
Jordens C.,
Little M.,
Kerridge I.,
McPhee J.
Publication year - 2005
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2005.00915.x
Subject(s) - advance care planning , medicine , contingency , process (computing) , engineering ethics , management science , ethical issues , risk analysis (engineering) , palliative care , nursing , epistemology , computer science , economics , philosophy , engineering , operating system
This paper uses a case example to review the current legal status of advance directives, as well as their ethical rationale. We draw attention to ongoing efforts to institutionalize advance directives, and to some of the tractable and intractable reasons why advance directives are ineffective. We then introduce the concept of advance care planning, and argue that we should not assume that advance care directives have a place in this process. We conclude by offering three reasons why this assumption may operate, and by suggesting that contingency and uncertainty may sometimes overwhelm all rational approaches to medical care. (Intern Med J 2005; 35: 563–566)