Advance directives. Good, bad or indifferent

Abstract

The author writes about various alternatives once decisional capacity is lost. So-called advance directives come in two forms: the living will and an appointed proxy for health care. The US--were these have been legally binding for over 20 years in all states--is a useful laboratory for studying the effect. Advantages and disadvantages are discussed. In some civilizations decisions about all such matters are made in different ways--these are not superior or inferior but simply different. In the US with its shameful social conditions for a large part of the population more important problems need to be addressed. In civilizations which have at least basic medical care for all, discussing such documents becomes far more important. The EU is likely to make some form of advance directive have legal standing. The last 20 or more years that they have been utilized in the US may provide experience important for the time when the EU also makes such documents legally binding.