Advance Directives and the Pursuit of Death with Dignity

An advance medical directive is a device aimed at controlling medical intervention during the dying process after a patient is no longer competent. Because of its ambiguous legal status and the ambivalence of medical personnel, it is still uncertain whether the advance directive will be a successful tool in the individual's struggle to retain a modicum of dignity in the face of modern life-prolonging technology. After examining the issues surrounding future-oriented medical decision making, Cantor outlines the legal foundation and framework governing advance directives and considers how such documents should be drafted in light of that legal framework. He suggests guidelines for implementing advance medical directives, anticipating the major problems likely to confront administrators of such directives, and discusses possible channels for enforcement of directives when health-care providers balk at implementation. Finally, he considers the moral foundation and the moral limits of future-oriented autonomy. This book will be an important resource for any person involved in the design or application of an advance medical directive - physicians, nurses, hospital social workers, administrators of health-care institutions, lawyers, clergy, and lay people seriously concerned about exercising control over the dying process in today's high-tech medical environment.