Advance Directives Outside the USA: Are They the Best Solution Everywhere?
Sanchez-Gonzalez, Miguel A.
Theoretical Medicine. 1997 Sep; 18(3): 283-301.
This article evaluates the potential role of advance directives outside of their original North American context. In order to do this, the article first analyses the historical process which has promoted advance directives in recent years. Next, it brings to light certain presuppositions which have given them force: atomistic individualism, contractualism, consumerism and entrepreneurialism, pluralism, proceduralism, and "American moralism." The article next studies certain European cultural peculiarities which could affect advance directives: the importance of virtue versus rights, stoicism versus consumerist utilitarianism, rationalism versus empiricism, statism versus citizens' initiative, and justice versus autonomy. The article concludes by recognising that autonomy has a transcultural value, although it must be balanced with other principles. Advance Directives can have a function in certain cases. But it does not seem adequate to delegate to advance directives more and more medical decisions, and to make them more binding everyday. It is indispensable to develop other decision-making criteria.
Advance Care Planning; Advance Directives; Allowing to Die; Autonomy; Beneficence; Bioethics; Communitarianism; Contracts; Cultural Pluralism; Consent; Decision Making; Ethical Relativism; Ethics; Family Members; Guidelines; Historical Aspects; Informed Consent; International Aspects; Justice; Legal Aspects; Medicine; Moral Policy; Morality; Organizations; Patients; Patients' Rights; Personhood; Philosophy; Physician Patient Relationship; Physicians; Public Policy; Refusal to Treat; Resource Allocation; Rights; Risks and Benefits; Secularism; Third Party Consent; Trust; Utilitarianism; Values; Virtues; Withholding Treatment; Wills;
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