Is an advance directive the path to a good end?A reflective text
An advance directive is a pre-instruction for end-of-life or terminal medical care.In June 2022,Shenzhen included advance directives in its local regulations.Compared to the widespread praise,the critical viewpoints are few.Since its origination in the United States nearly five decades ago,the assessments of its effectiveness have shown that advance directives have not fulfilled their intended promises.They neither advanced the earlier use of palliative care nor reduced the use of life-sustaining treatment,nor did they decrease end-of-life medical expenses or facilitate doctor-patient communication.The standardized text is challenging to apply in the intricacy,urgency of terminal medical care.This paper explores the research topic from two distinct dimensions,"relationality"and"uncertainty".The end of life is a relational event where others'assistance might not necessarily infringe on autonomy;instead,it might promote it.The paper also discusses the issues related to the uncertainties concerning medical situations,patient wishes and disease trajectories.In conclusion,the conceptual significance of advance directives outweighs their practical significance;what is important is to provide high-quality end-of-life care rather than to make choices within a standardized text.
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