An Examination of the Moral Authority of Use of Advance Directives with the Alzheimer's Dementia Population
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Date
2010-01-22T18:48:03Z
Authors
Sokolowski, Marcia
Journal Title
Journal ISSN
Volume Title
Publisher
University of Waterloo
Abstract
Advance directives in Canada are instructions made by capable adults that pertain to future healthcare treatment choices at a time of incapacity. My experience as an ethicist working in an Ontario long-term care facility that provides medical treatment to patients with Alzheimer’s Dementia portrays a range of important ethical concerns that arise out of the use of advance directives, at least in terms of their current use. In this thesis I analyze composite case studies to identify the more prominent challenges that exist and I turn to the literature to seek ways to more clearly understand these problems and to determine if they can be overcome. What I conclude is that the use of advance directives with the Alzheimer’s Dementia population in long-term care, as it is currently used, is fraught with problems that are mainly irresolvable. I offer clinical and policy recommendations that are aligned with this view.
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Keywords
advance directives, living wills, autonomy, relational automony, Alzheimer's Dementia, competency, long-term care, informed consent, advance care planning, substitute decision-making