Opinion on advance directives (living wills)

Swedish National Council on Medical Ethics
Date: 2005-09-02


This opinion was issued on request by the Ministry of Justice and deals with a report by a committee that had reviewed the area legal substitutes for adults. The Council welcomes the proposals about clearer rules for legal substitutes for adults with reduced decision-making capabilities in health care, an important but neglected area. In its remarks, the Council limits itself to the proposals in this area and especially the questions around so called “end-of-life directives”. The Council holds the opinion that these directives should be given more weight than that proposed by the committee. The term “end-of-life directive” is however inappropriate for binding directives concerning future life sustaining treatment since, according to the Council, this type of document should be respected not only when the patient is irreversibly dying or in a permanent state of unconsciousness. Therefore the term “care directive” or more exact “advance directive on life sustaining treatment” would be preferable. In the opinion the Council makes an extensive analysis of decision making situations including case studies.