Medisinsk behandling og bindende forhåndsønsker- Noe for Norge? : En oversikt og diskusjon om verdien av forhåndsønsker og pasientens rett til å oppnevne stedfortredende beslutningstaker

Abstract

A patient’s opportunity to affect and participate in decision-making with regard to their own medical care is considered important. Most patients want some control over their medical care, including or even especially, when they are too sick to participate in decisions about their care. A patient unable to consent, will, if no measure is taken, depend entirely upon others to control their future. Advance care planning can help overcome the limitation of a patient’s mental incapacity of participating in health-care decision-making, though it seems that both advance directives and durable powers of attorney/proxy advance directives may promise more control over future care than what is possible to obtain. The ethical and juridical dilemmas concerning incompetent patients arise when life-sustaining treatment no longer surely benefits the patient. These dilemmas are handled in various ways from one country to another. Professional discussions and certain difficult cases exposed in media lately have suggested the need for a common guidance in Norway acting as a framework for health personnel facing treatment-decisions for mentally incompetent patients as well as those competent to make decisions. This has led to recent guidelines for the decision-making process concerning life-sustaining treatment of seriously ill and dying patients in Norway. This paper will look at the pros and cons of advanced directives and proxy directives. A glance at the healthcare laws in countries with and without the possibility for binding advance care planning makes the base for my discussion leading to the question of what’s the best option for the Norwegian patients and the healthcare system in Norway.