Horn Ruth Judith
Centre for Ethics in Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK,
Health Care Anal. 2014 Mar;22(1):59-72. doi: 10.1007/s10728-012-0210-7.
In Western societies advance directives are widely recognised as important means to extend patient self-determination under circumstances of incapacity. Following other countries, England and France have adopted legislation aiming to clarify the legal status of advance directives. In this paper, I will explore similarities and differences in both sets of legislation, the arguments employed in the respective debates and the socio-political structures on which these differences are based. The comparison highlights how different legislations express different concepts emphasising different values accorded to the duty to respect autonomy and to protect life, and how these differences are informed by different socio-political contexts. Furthermore each country associates different ethical concerns with ADs which raise doubts about whether these directives are a theoretical idea which is hardly applicable in practice.
在西方社会，预立医疗指示被广泛视为在患者无行为能力的情况下扩展其自我决定权的重要手段。效仿其他国家，英国和法国已通过立法，旨在明确预立医疗指示的法律地位。在本文中，我将探讨这两套立法中的异同、各自辩论中所采用的论据以及这些差异所基于的社会政治结构。这种比较凸显了不同立法如何表达不同的概念，强调赋予尊重自主权和保护生命义务的不同价值观，以及这些差异如何受到不同社会政治背景的影响。此外，每个国家将不同的伦理关切与预立医疗指示联系在一起，这引发了对于这些指示是否是一个在实践中几乎无法适用的理论概念的质疑。
