Document Detail


'Vague Oviedo': autonomy, culture and the case of previously competent patients.
MedLine Citation:
PMID:  20136823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The paper examines the ethical and legal challenges of making decisions for previously competent patients and the role of advance directives and legal representatives in light of the Oviedo Convention. The paper identifies gaps in the Convention that result in conflicting instructions in cases of a disagreement between the expressed prior wishes of a patient, and the legal representative. The authors also examine the legal and moral status of informally expressed prior wishes of patients unable to consent. The authors argue that positivist legal reasoning is insufficient for a consistent interpretation of the relevant provisions of the Convention and argue that ethical argumentation is needed to provide guidance in such cases. Based on the ethical arguments, the authors propose a way of reconciling the apparent inconsistencies in the Oviedo Convention. They advance a culturally sensitive approach to the application of the Convention at the national level. This approach understands autonomy as a broader, relational consent and emphasizes the social and cultural embeddedness of the individual. Based on their approach, the authors argue that there exists a moral obligation to respect the prior wishes of the patient even in countries without advance directives. Yet it should be left to the national legislations to determine the extent of this obligation and its concrete forms.
Authors:
Assya Pascalev; Takis Vidalis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bioethics     Volume:  24     ISSN:  1467-8519     ISO Abbreviation:  Bioethics     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704792     Medline TA:  Bioethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  145-52     Citation Subset:  E; IM    
Affiliation:
Department of Community and Family Medicine, College of Medicine, Howard University, 500 W Street NW, Washington, DC 20059, USA. director@bio-ethics.net
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MeSH Terms
Descriptor/Qualifier:
Advance Directives / ethics,  legislation & jurisprudence*
Cultural Diversity*
Europe
Humans
Informed Consent / ethics,  legislation & jurisprudence*
International Cooperation*
Moral Obligations
Proxy*
Terminal Care / ethics,  legislation & jurisprudence*

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