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- W2035665621 abstract "Editor—Those of us who have made advance directives can only be dismayed and concerned by Thompson et al's assumption that there will always be ambiguity.1 Firstly, doctors can strangely assume that patients might aspire to spend their last days demented in a residential home. Secondly, this assumption is enough to justify giving an antibiotic to prolong everyone's agony, mainly that of the patient.Prescribing an antibiotic is the easy option; many of us have done it. I will always remember the withering look coupled with the remark “Why did you do it?”of a most distinguished, very elderly lady to whom I administered a parenteral antibiotic when she was delirious with pneumonia. She recovered and eventually developed dementia. There was no alternative to the antibiotic: there was no advance directive. Higgs commented in the BMJ that pneumonia, the old person's friend, may be dismissed with a wave of the prescribing pen—but what if the old person wishes the friend to call?2What can be done to counteract the ambiguity? The hypothetical advance directive, although apparently fully comprehensive and perhaps thought to be irrefutable, should additionally include:A statement of general beliefs and aspects of life that the person values. My own statement is long and detailed and includes the hope that I will not end up a burden to my carers, and that I will not have inflicted on me a meaningless struggle against unacceptable mental or physical disability by my doctorsA statement naming a proxy who would help the doctors with interpreting the advance directive.If my directive with these additions is still ignored I hope that my relatives would not hesitate to sue for assault or negligence." @default.
- W2035665621 created "2016-06-24" @default.
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- W2035665621 date "2003-12-13" @default.
- W2035665621 modified "2023-09-25" @default.
- W2035665621 title "Adherence to advance directives: Advance directive needs to include additional elements" @default.
- W2035665621 cites W2075718158 @default.
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- W2035665621 doi "https://doi.org/10.1136/bmj.327.7428.1407-a" @default.
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