Early Wills

Respect for the management of one's own life (included in the bioethical principle of Autonomy) implies the right of every adult, capable, in the absence of coercion and duly informed, to decide whether or not to accept a certain treatment, that is, to decide what he or she considers good for himself or herself, which on occasion may not coincide with medical opinion.

In situations of inability to express one's opinion, the best way to preserve that right for the patient is the Advance Directives (AV), also called prior instructions, advance directives or living wills. A VA is a process in which a person plans for the health care he or she wants to receive or refuse in the future, particularly for the time when he or she is unable to make decisions for himself or herself. It should be the result of the doctor-patient relationship and, as far as possible, carried out with the participation of a representative appointed by the patient.

It can be done by anyone and in the case of patients with chronic diseases where the way they get worse is predictable, it can be very useful.

Patients have the right to participate in the plan of care and health professionals have a professional and legal responsibility to ensure this participation, bearing in mind that good medical practice is no longer good if it does not respect the will of the patient. It is not a matter of the patient indicating the treatment, but of choosing between the most reasonable options.

The main objective of the VA is to ensure that, when the patient has lost the ability to participate in decision-making, the health care is in accordance with the preferences he or she has previously expressed.

The secondary objectives are to improve the health decision-making process, optimise the patient's well-being and alleviate the burden on loved ones. VA is a useful instrument to improve dialogue and foster the care relationship for both the patient and his/her relatives, as well as for professionals.

Therefore, VA is part of care planning, understood as a positive process of reflection and involvement of citizens in decisions regarding their health, in accordance with their personal values within the framework of the doctor-patient/family relationship.

In the context of the healthcare relationship, the patient's wishes can be expressed orally and recorded in the medical record; however, the best way to ensure compliance in all circumstances is to do so through the so-called Advance Directives.

Source: Osakidetza – Servicio Vasco de Salud. Enlace

Conference “Aula Mémora” 25 de Mayo de 2017 – Centro Rezola Enlace