Department of Philosophy, University of Turku, Finland.
Bioethics. 2011 Nov;25(9):505-15. doi: 10.1111/j.1467-8519.2009.01799.x. Epub 2010 Feb 3.
In this article, I consider whether the advance directive of a person in minimally conscious state ought to be adhered to when its prescriptions conflict with her current wishes. I argue that an advance directive can have moral significance after its issuer has succumbed to minimally conscious state. I also defend the view that the patient can still have a significant degree of autonomy. Consequently, I conclude that her advance directive ought not to be applied. Then I briefly assess whether considerations pertaining to respecting the patient's autonomy could still require obedience to the desire expressed in her advance directive and arrive at a negative answer.
在本文中，我考虑了当一个处于最小意识状态的人的预先指示与其当前意愿相冲突时，是否应该遵守该指示。我认为，预先指示在其签发人陷入最小意识状态后仍具有道德意义。我还为这样一种观点辩护，即患者仍然可以具有相当程度的自主性。因此，我得出结论，不应该适用她的预先指示。然后，我简要评估了尊重患者自主性的考虑因素是否仍然要求服从她预先指示中表达的愿望，并得出否定的答案。
