An advance directive is an instruction made by a competent person about his or her
preferred health care choices, should the person become incapable to make treatment
decisions. Legal recognition of advance directives has developed over the last half
century in response to medical advances that can prolong the life of a patient who is no
longer sentient, and who has decided to forego some or all treatment under such
circumstances. Two types of directive have emerged in the law: an instructional
directive, in which a person sets out treatment choices, and a proxy directive, which
enables the person to appoint a proxy to make treatment decisions.
Development of the law has been impeded by fear that advance directives diminish
regard for the sanctity of life and potentially authorize euthanasia or assisted suicide. In
Canada, this fear explains the continued existence of outdated criminal law prohibitions
and contributes to provincial advance directive legislation that is disharmonized and
restrictive, in some provinces limiting personal choice about the type of advance directive
that can be made. The British Columbia Representation Agreement Act (RAA)1 is an
example of such restrictive legislation. The RAA imposes onerous execution
requirements, is unduly complex and restricts choice of planning instrument.
Respect for patient autonomy requires that health care providers honour patients'
prospective treatment preferences. Capable persons must have ready access to a choice
of health care planning instruments which can be easily executed. B.C. should
implement advance directive legislation that meets the needs and respects the autonomy
of B.C. citizens. The Criminal Code must be amended to eliminate physicians' concern
about potential criminal liability for following an advance directive. Advance directive
legislation across Canada should be harmonized. Finally, health care providers should
receive training on effective ways to communicate with patients about end-of-life
treatment decisions to ensure that patients' health care choices are known and respected. / Law, Peter A. Allard School of / Graduate
| Identifer | oai:union.ndltd.org:UBC/oai:circle.library.ubc.ca:2429/17543 |
| Date | 05 1900 |
| Creators | Rush, Joan L. |
| Source Sets | University of British Columbia |
| Language | English |
| Detected Language | English |
| Type | Text, Thesis/Dissertation |
| Rights | For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use. |
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