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    Keatings & Adams, 2020, pp.200

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    Binu Kumar
    While advance directives aim to respect patient autonomy, a patient's interests may change due to illness or incapacity. This severs the link between respecting autonomy and ensuring patient welfare. Neither strictly following an advance directive (as a "Ulysses contract") nor solely considering a patient's current interests is satisfactory. To balance these concerns, advance care planning should involve regular review and updates to reflect any changes in a patient's wishes, with guidance from medical experts. This enhances patient trust in the process and medical institutions.

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    Keatings & Adams, 2020, pp.200

    Uploaded by

    Binu Kumar
    167 views2 pages
    While advance directives aim to respect patient autonomy, a patient's interests may change due to illness or incapacity. This severs the link between respecting autonomy and ensuring patient welfare. Neither strictly following an advance directive (as a "Ulysses contract") nor solely considering a patient's current interests is satisfactory. To balance these concerns, advance care planning should involve regular review and updates to reflect any changes in a patient's wishes, with guidance from medical experts. This enhances patient trust in the process and medical institutions.

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    While advance directives aim to respect patient autonomy, a patient's interests may change due to illness or incapacity. This severs the link between respecting autonomy and ensuring patient welfare. Neither strictly following an advance directive (as a "Ulysses contract") nor solely considering a patient's current interests is satisfactory. To balance these concerns, advance care planning should involve regular review and updates to reflect any changes in a patient's wishes, with guidance from medical experts. This enhances patient trust in the process and medical institutions.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    167 views2 pages

    Keatings & Adams, 2020, pp.200

    Uploaded by

    Binu Kumar
    While advance directives aim to respect patient autonomy, a patient's interests may change due to illness or incapacity. This severs the link between respecting autonomy and ensuring patient welfare. Neither strictly following an advance directive (as a "Ulysses contract") nor solely considering a patient's current interests is satisfactory. To balance these concerns, advance care planning should involve regular review and updates to reflect any changes in a patient's wishes, with guidance from medical experts. This enhances patient trust in the process and medical institutions.

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    Do you agree or disagree with London and Kestigian's argument that if, due to illness or

    incapacity, patients' interests change, then the link between respect for autonomy and

    fidelity to patent welfare is severed? Should we pay attention to the "then-self versus now-

    self" distinction in making our assessments, or should we treat advance directives as a sort

    of Ulysses contract (i.e., a freely made decision that is intended to be binding in the future)?

    While preparing an advance directive, individuals cannot anticipate every possible

    complexity of the proposed treatment. So, their preferences may change over time due to illness

    or incapacity. In cases where the advance care plan conflicts with the current interest, it is not

    easy to choose between the options. Executing any one of the choices will either disrespect the

    patient's authentic wishes or unfavorably affect the fidelity policy. So, I agree with London and

    Kestigian's argument that, due to illness or incapacity, patients' interests change, then the link

    between respect for autonomy and fidelity to patent welfare is severed. 

    In my perception, considering the patient's current interests rather than valuing

    interests that the patient expressed when they are competent will result in breaking their trust

    and autonomy to make decisions regarding their health care matters. However, treating

    advance directive solely as a sort of Ulysses contract have deficiencies as it is not

    exploring every possibility in advance or their future state of mind and circumstances (Keatings

    & Adams, 2020, pp.200). So, integrating the advance directive in such a way to uphold honesty,

    transparency, and patient's trust is a possible option to alleviate the potential problems.

    Constructing a life value advance directive that lets the client express what they value most will

    avoid potential complex issues in decision-making. Additionally, individuals who create the

    advance directive should let appropriate people know the existence of the will and ensure that

    the will is reviewed and updated regularly to reflect the client's current wishes. Consultation
    with physicians, nurses, and lawyers will help them to anticipate the situations that may arise

    and also helps them to make sound decisions (Keatings & Adams, 2020, pp. 200). 

    In a nutshell, all the concerns should be addressed during the advance care planning

    process, and patients should be made aware that their interests may change over time and that

    their evaluation of future health states may be colored by present values that they may not retain

    in that future state. This enhances patient's trust and the legitimacy of the institution (Kestigian &

    London, 2016)

    References

    Keatings, M., & Adams, P. (2020). Ethical and Legal Issues in Canadian Nursing (4th ed.).

    Elsevier.

    Kestigian, A., & London, A. J. (2016). Adversaries at the Bedside: Advance Care Plans and

    Future Welfare. Bioethics, 30(8), 557–567. https://doi.org/10.1111/bioe.12263

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