Historical Review of Advance Directives

  • Alfred Simon
Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 54)


As medicine progresses, many people are increasingly concerned about being dependent on physicians in times of severe illness. The wish to influence future medical treatment, and especially to refuse measures such as mechanical ventilation, artificial nutrition and cardiopulmonary resuscitation in certain situations, led to the development of advance directives. These provide instructions for situations in which the patient is no longer able to consent to or refuse medical treatment. Various kinds of advance directives were developed in the US in the 1970s and 1980s, and subsequently also in other countries. Today, regulations governing the validity and legal authority of advance directives exist in the US and in many European countries. The fact that these regulations differ widely reflects the varying importance attached by different countries to patient autonomy, on the one hand, and the obligation of physicians or the state to provide care and protect human life, on the other.


Advance Directive Legal Regulation Advance Care Planning Artificial Nutrition Psychological Continuity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



I wish to thank Linda Hüllbrock for assistance with translation and Bernd Alt-Epping for constructive criticism.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Academy for Ethics in MedicineGöttingenGermany

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