In the quarter century since the landmark Karen Ann Quinlan
case, an ethical, legal, and societal consensus supporting
patients' rights to refuse life-sustaining treatment has become a
cornerstone of bioethics. Patients now legally can write advance
directives to govern their treatment decisions at a time of future
incapacity, yet in clinical practice their wishes often are
ignored.
Examining the tension between incompetent patients' prior wishes
and their current best interests as well as other challenges to
advance directives, Robert S. Olick offers a comprehensive argument
for favoring advance instructions during the dying process. He
clarifies widespread confusion about the moral and legal weight of
advance directives, and he prescribes changes in law, policy, and
practice that would not only ensure that directives count in the
care of the dying but also would define narrow instances when
directives should not be followed. Olick also presents and develops
an original theory of prospective autonomy that recasts and
strengthens patient and family control.
While focusing largely on philosophical issues the book devotes
substantial attention to legal and policy questions and includes
case studies throughout. An important resource for medical
ethicists, lawyers, physicians, nurses, health care professionals,
and patients' rights advocates, it champions the practical,
ethical, and humane duty of taking advance directives seriously
where it matters most-at the bedside of dying patients.
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