Making Sense of Advance Directives

1. Front Matter

   Pages i-x

   PDF

2. Introduction

   • Nancy M. P. King

   Pages 1-26

3. Treatment Refusal and the Patient’s Choice: Foundations in History, Law, and Ethics

   • Nancy M. P. King

   Pages 27-63

4. The “Future Factor”: The Conceptual Foundations of Advance Directives

   • Nancy M. P. King

   Pages 65-93

5. Advance Directives: Current Forms, Legal Fears, Moral Goals

   • Nancy M. P. King

   Pages 95-148

6. When Choices Fail

   • Nancy M. P. King

   Pages 149-174

7. The Forecast For Advance Directives: Indispensable or Superfluous?

   • Nancy M. P. King

   Pages 175-193

8. Back Matter

   Pages 195-215

   PDF

The first time I read the medical consent and authorization. it had registered in my mind simply as a legal document. Now I began to understand what it meant. It was a letter of ultimate love and trust. (Schucking. 1985. p. 268) Ever since Karen Ann Quinlan slipped into permanent unconsciousness in 1975 and her father agonized publicly over whether she should remain indefinitely on a respirator (In re Quinlan, 1976), the desires of patients, their families, and their friends to limit the application of apparently limitless medical technology have been a pressing concern for ethics, law, and public policy. Ms. Quinlan's case contained nearly all the elements of the problems we still face: vague, general, but sincere prior oral statements suggesting that she would not want continued treatment; a family attempting to do what they saw as best for her; and physicians uncertain whether to use medical judgment alone (and if so, what the "right" medical decision was), to preserve her life at all costs, or to honor the family's interpretation of their daughter's choice. Most ironically, once she was removed from her respirator, she did not die. Karen Quinlan - like dozens of other names made famous by court decisions, newspaper stories, and television evening news - has come to symbolize a tangled knot of issues surrounding the end of life and who controls it.

• concept
• consciousness
• ethics
• foundation
• history
• history of literature
• interpret
• love
• mind
• morality
• policy
• register
• television
• trust

' Making Sense of Advance Directives is the best single book on this timely topic. It should be not only in the collections of academic libraries, but also in those of community and hospital libraries and in the reading rooms of ethics committees and clinical departments. ' Medical Humanities Review 6:2 1992

• Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, USA

  Nancy M. P. King

Policies and ethics