Advance Care Directives:

Not Just for End of Life?

Sandra L BradleyKathy WilliamsJean E Murray

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Dementia Risk

3 out of 4 Australians would take a test to predict their risk of developing Alzheimer’s disease if it were available.O They would like to know by the age of 41O More women than men would like to know(McLean, T ‘Most want to predict dementia risk’, Adelaidenow , 17 Feb 2008)

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The Ethics: Respect for autonomy

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Meaning- “self-government, self-sufficiency, self-determination” (Chan, H 2004, Bioethics, vol.18, no.2)

Origin – Western common law-based countries.

Importance – embedded in common law as a fundamental human right where actions on a person’s body without their consent equates to battery (Kerridge, I., Lowe, M., & Stewart, C. (2009). Ethics and Law for the Health Professions (3rd ed.).

Advance Care Directives – meant to protect patient autonomy in medical treatment and health care more broadly, including personal decisions about quality of life issues and choices.

Question 1: Should ACDs for younger and healthier generations be encouraged from the perspective of personal autonomy or from a different perspective, such as ACDs being a social and community responsibility?

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Question 2: Can healthy Boomers adequately describe unwanted outcomes or circumstances they prefer to avoid with confidence that clinicians and SDMs will understand and be able to act upon these expressed wishes?

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Advance Care Directives – assisting the process?

Advance Care Directives not onlypromote choice: they preserve

and respect personal autonomy

But at what cost?

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