title: Advance directives in english and French law: different concepts, different values, different societies.
abstract: In Western societies advance directives are widely recognised as important means to extend patient self-determination under circumstances of incapacity. Following other countries, England and France have adopted legislation aiming to clarify the legal status of advance directives. In this paper, I will explore similarities and differences in both sets of legislation, the arguments employed in the respective debates and the socio-political structures on which these differences are based. The comparison highlights how different legislations express different concepts emphasising different values accorded to the duty to respect autonomy and to protect life, and how these differences are informed by different socio-political contexts. Furthermore each country associates different ethical concerns with ADs which raise doubts about whether these directives are a theoretical idea which is hardly applicable in practice.
authors.affiliation: Centre for Ethics in Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK, ruth.horn@bristol.ac.uk.
authors.forename: Ruth Judith
authors.initials: RJ
authors.lastname: Horn
mesh_terms: D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence*; D004739:England; D005602:France; D006806:Human Rights; D006801:Humans; D005791:Patient Care / Q000941:ethics; D026684:Personal Autonomy; D011057:Politics; D012931:Social Environment