Advance Directives and the Pursuit of Death with Dignity

'Cantor provides a very thorough, reliable, and readable guide that should be in the personal library of lawyers, clergy, and social workers as well as those in health care who have responsibility for helping patients execute advance directives' - Robert M. Veatch, Director, Kennedy Institute of Ethics, Georgetown University.An advance medical directive (living will) is a device aimed at controlling medical intervention during the dying process after a patient is no longer competent. Because of its ambiguous legal status and the ambivalence of medical personnel, it is still uncertain whether the advance directive will be a successful tool in the individual's struggle to retain a modicum of dignity in the face of modern life-prolonging technology. After examining the issues surrounding future-oriented medical decision making, Cantor outlines the legal foundation and framework governing advance directives and considers how such documents should be drafted in light of that legal framework. He suggests guidelines for implementing advance medical directives and discusses possible channels for enforcement of directives when health care providers balk at implementation. Finally, he considers the moral foundation and the moral limits of future-oriented autonomy.