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Reassessing the Reliability of Advance Directives

  • Thomas May (a1)

A competent patient has the right to refuse treatment necessary to sustain life. However, for many end-of-life decisions, we lack direct access to the wishes of a competent patient. Some treatment decisions near the end of life involve patients with severely diminished mental capacity (for example, Alzheimer's patients), some involve patients who are unable to communicate (for example, some stroke victims), and some involve patients who are simply unable or unwilling to participate in decisionmaking due to the nature or severity of their illness.

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J Radden . Planning for mental disorder: Buchannan and Brock on advance directives. Social Theory and Practice 1992;18(2).

EF McClennen . Rationality and Dynamic Choice. Cambridge: Cambridge University Press, 1990.

R Dresser . Bound to treatment: the Ulysses contract. Hastings Center Report 1984;14(3):13–6.

M Winston Can a subject consent to a “Ulysses Contract”? Hastings Center Report 1982;12(4):26–8.

T May . The nurse under physician authority. Journal of Medical Ethics 1993;19(4):223–7.

L Emanuel Advance directives for medical care—a case for greater use. New England Journal of Medicine 1991;324(13):889–95.

J Drane . The many faces of competency. Hastings Center Report 1985;15(2):1721.

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Cambridge Quarterly of Healthcare Ethics
  • ISSN: 0963-1801
  • EISSN: 1469-2147
  • URL: /core/journals/cambridge-quarterly-of-healthcare-ethics
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