Remembrance of conversations past: oral advance statements about medical treatment.

Abstract:

:Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in medical notes. Without documentation, dilemmas arise when others claim to know patients' views on the basis of past unrecorded conversations and demand withdrawal of treatment when patients are not terminally ill and cannot speak for themselves. Legal and ethical considerations oblige doctors to act in the best interests of an incapacitated patient; these considerations are now formally defined in draft legislation as including consideration of the patient's past wishes. The practicalities of ascertaining the strength and validity of such wishes from conversations reported second hand are complex. The paucity of legal and ethical guidance on reported oral advance statements makes debate imperative and renders the alternative of having designated surrogate decision makers increasingly attractive.

journal_name

BMJ

authors

Sommerville A

doi

10.1136/bmj.310.6995.1663a

subject

Has Abstract

pub_date

1995-06-24 00:00:00

pages

1663-5

issue

6995

eissn

0959-8138

issn

1756-1833

journal_volume

310

pub_type

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