title: [Advance directives from the medical viewpoint].
abstract: Advance directives, enabling patients to declare their wishes and preferences for future situations, when they no longer are able to communicate, appear to be attractive. The concept, however, is based on two important presuppositions: First on the recognition of the right of self-determination. Second, it is assumed that a patient can direct medical care not only hic et nunc, but can advance autonomy into future incompetent states. It is the second presupposition that causes most of the ethical concerns and practical problems. Some of the limitations can possibly be overcome, or at least minimized, by careful drafting, frequent revision and the appointment of a proxy. However, advance directives should be integrated into the process of patient information and care.
authors.affiliation: Abteilung für Hämatologie und Onkologie, Medizinischen Hochschule Hannover, Deutschland.
authors.forename: J G
authors.initials: JG
authors.lastname: Meran
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence*; D001317:Austria; D004992:Ethics, Medical; D005858:Germany; D006801:Humans; D007872:Legal Guardians; D016743:Mental Competency / Q000331:legislation & jurisprudence; D010817:Physician-Patient Relations