The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo). The new law deals with relevant issues that were confined to jurisprudential rulings so far, such as the informed consent, the withdrawal/withholding of medical treatment (including artificial nutrition and hydration), the content of medical information, including the modalities, the medical responsibility and, finally, the value of advance directives. In the Authors' opinion this law provides essential rules to expressly strengthen the patients' autonomy, eliminating the juridical uncertainty on many central issues (such us, for example, the refusal of life-sustainment treatments) that have been the subject of contradictory judgments ruled by the Italian Courts. Nevertheless, advance directives should be regarded as a dynamic tools of relationship between physicians and assisted person and, thus, as an essential integrant part of the advance care planning. The education of health professionals and citizens about end of life issues is the basis for the successful implementation of this legislation.
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http://dx.doi.org/10.1701/2902.29245 | DOI Listing |
Int Marit Health
January 2025
Faculty of Law, University of Macau, E32 Avenida da Universidade Taipa, 999078 Macao, China.
This paper delves into the unexplored area of Advance Directives (ADs) in maritime surroundings, diving into the moral and legal quandaries that crop up when these directives are used at sea. ADs, which include durable powers of attorney and living wills, are essential documents that indicate a person's wishes for healthcare in the event of incapacitation. Global variations in legal recognition pose ethical questions, particularly in non-regulated jurisdictions.
View Article and Find Full Text PDFBMC Med Ethics
December 2024
Department of Public Health and Infectious Diseases, Section of Medical Statistics, Sapienza Università di Roma, Rome, Italy.
Background: There is wide convergence in the positions of scientific societies, patient associations and public bodies regarding the advisability of advance care planning (ACP) in cognitive disorders and dementia to respect the specificity of the person. Nevertheless, planning in advance for dementia represents a unique challenge. In Italy, law n.
View Article and Find Full Text PDFPLoS One
December 2024
Stony Brook University Hospital, Stony Brook, New York, United States of America.
Despite the benefits of Advance directives, approximately only 1 in 3 U.S adults have documented advance directives. In medical school and residency, learners are often not taught or given very brief information on conducting end-of-life planning conversations with patients.
View Article and Find Full Text PDFJ Hosp Palliat Care
December 2024
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si and Department of Medicine, College of Medicine, Dongguk University, Seoul, Korea.
Advance care planning (ACP) in palliative care is essential for patient autonomy and quality of dying. This review explores ACP practices in South Korea, Japan, and Taiwan, highlighting how legislation and cultural values shape those practices. In these three sectors, which are influenced by Confucian values, family involvement plays a significant role in decision-making.
View Article and Find Full Text PDFJ Law Med Ethics
December 2024
DUKE UNIVERSITY, DURHAM, NORTH CAROLINA, USA.
As increasing proportions of our global population age, transgender people are experiencing higher rates of dementia, and many are afraid to enter long-term care. Structural interventions such as advance directives may help mitigate fears around entering long-term care by managing specific anxieties that transgender people may have about dementia, loss of decision-making capacity, and discrimination in long-term care settings.
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