Document on living wills
| Páginas | 73-86 |
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The Opinion Group of Bioethics and Law Observatory, based at the Parc Científic de Barcelona, was formed to study the ethical, social and legal implications of new biotechnology techniques from a scientific and multidisciplinary point of view, and to make specific proposals for legislative action.
The Bioethics and Law Observatory itself was created with a view to participating in the university-society dialogue and making its voice heard in the wider society; more specifically its aim was to make submissions to the public, administrative and political bodies which regulate and control research and the application of new technologies. To achieve these aims it is also necessary to maintain a fluid relationship with the media, so as to improve the quality of information available. In the light of this objective the Group has already published Declarations on issues which had given rise to debate both among the public and the scientific community.
In this present document, the Group presents a model for a Living Will which, it is hoped, will serve for expression of an individual’s wishes with regard to the medical treatment he or she wishes to receive or not to receive in certain well-defined future circumstances in which the declarant cannot express these wishes; the aim is to facilitate exercise of the personal autonomy provided for by Law.
The group has been coordinated by Dr. Albert Royes i Qui, Professor of Medical Ethics at the Faculty of Medicine of UB, and has received submissions from specialists in medicine, nursing, philosophy, biology, anthropology and law, as acknowledged at the end of the document.
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The Opinion Group of Bioethics and Law Observatory, based at the Parc Científic de Barcelona, believes that the rights of the patient and the principle of personal autonomy are central to the patient-doctor and patient-health authorities relationships. These rights are particularly relevant, but not exclusively so, in the areas of information and consent.
The group holds that personal freedom and, therefore, personal autonomy, are especially important in health care. The advance decisions a person may take in anticipation of a possible future situation in which he is unable to participate effectively in decisions concerning his health care, are particularly important in this respect.
Law 21/2000, of 29 December was published in the Diari Oficial de la Generalitat de Catalunya on 11 January, 2001. It set out the patient’s right to information and personal autonomy in relation to health care and clinical documentation.
Article 8 of this law makes provision for previously expressed wishes, as set out in the Council of Europe Convention on Human Rights and Biomedicine of 4 April 1997, which states "The previously expressed wishes relating to a medical intervention by a patient who is not, at the time of the intervention, in a state to express his or her wishes shall be taken into account." (Article 9).
We believe that the introduction of Living Wills, in addition to the concept of informed consent and the right to information, will have a profound effect on traditional patient- health professional relations, hitherto characterised by a paternalistic attitude on the part of the medical profession which could be viewed as a deprivation of certain of the patient’s rights. The will to change this situation is positive; however, we recognise that such far-reaching changes in an area of deep-rooted practices will not take place overnight and will require an educational campaign on the part of medical institutions and especially the Medical Ethics Committees. It will also be necessary for the public to demand and exercise their right to complete Living Wills.
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