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Open Access 01-06-2009 | Original Article

Interpreting Advance Directives: Ethical Considerations of the Interplay Between Personal and Cultural Identity

Author: Silke Schicktanz

Published in: Health Care Analysis | Issue 2/2009

Abstract

In many industrialized countries ethicists and lawyers favour advance directives as a tool to guarantee patient autonomy in end-of-life-decisions. However, most citizens seem reluctant to adopt the practice; the number of patients who have an advance directive is low across most countries. The article discusses the key argument for seeing such documents as an instrument of self-interpretation and life-planning, which ultimately have to be interpreted by third parties as well. Interpretation by third parties and the process of self-reflection are conceptually linked by a qualitative concept of identity. Identity is conceived here as constructed in a processual dialogue between a personal and a cultural perspective. How the cultural dimension comes into play in understanding the motivation, rejection or content of wished for end-of-life-decisions, is shown by a brief review of empirical and cultural studies. Understanding advance directives as a culturally embedded tool of self-interpretation should help to overcome urgent moral problems in clinical settings: how to interpret such documents, how to deliberate on the content and on the best form.

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Title: Interpreting Advance Directives: Ethical Considerations of the Interplay Between Personal and Cultural Identity
Author: Silke Schicktanz
Publication date: 01-06-2009
Publisher: Springer US
Published in: Health Care Analysis / Issue 2/2009
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI: https://doi.org/10.1007/s10728-009-0118-z

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Interpreting Advance Directives: Ethical Considerations of the Interplay Between Personal and Cultural Identity

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