Taking advance directives seriously : prospective autonomy and decisions near the end of life

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.Offering a comprehensive argument for favouring advance instructions during the dying process, this book clarifies widespread confusion about the moral and legal weight of advance directives, and 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.

It also presents and develops an original theory of prospective autonomy that recasts and strengthens patient and family control.An resource for medical ethicists, lawyers, physicians, nurses, health care professionals, and patients' rights advocates, the book champions the practical, ethical, and humane duty of taking advance directives seriously where it matters most - at the bedside of dying patients.