Abstract

FORERO, Jenny; VARGAS, Ivonne  and  BERNALES, Margarita. Advance Directives: Ethical Challenges in Patient Care. pers.bioét. [online]. 2019, vol.23, n.2, pp.224-244. ISSN 0123-3122.  https://doi.org/10.5294/pebi.2019.23.2.5.

Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords “Advance Healthcare Directive” AND “Ethical Implication” and its Spanish equivalents (voluntades anticipadas, implicaciones éticas), five databases were accessed: ProQuest, Philosophy (JSTOR), PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient’s values and wishes, so it is vital to train them to provide respectful quality care.

Keywords : advance directive; health care advance directive; living will; disclosure; advance directives; ethical principles; decision making; clinical decision-making.

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