Advance Directives and Surrogate Decision Making before Death

• Published in: The New England journal of medicine Vol. 363; no. 3; pp. 295 - 296
• Main Authors: Kierzek, Gerald, Rac, Valeria, Pourriat, Jean-Louis, Henrikson, Charles A, Silveira, Maria J, Gillick, Muriel R
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 15.07.2010
• Subjects: Advance Directives - legislation & jurisprudence; Advance Directives - statistics & numerical data; Conflicts of interest; Decision making; France; Health care; Humans; Patient Participation - legislation & jurisprudence; Personal Autonomy; Physician-Patient Relations; Proxy; Right to die; United States; France; United States
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMc1005312

To the Editor: In their Special Article on advance directives, Silveira et al. (April 1 issue) 1 recommend the continued use of advance directives and especially durable power of attorney for health care. From a European viewpoint, we are very impressed by the percentage of decedents who reportedly had an advance directive (67.6%) among subjects who lacked decision-making capacity. We are also surprised by the power of a surrogate to overrule all decisions, even when surrogate decisions are inconsistent with the patient's written preferences. We acknowledge that the U.S. model of the patient–physician relationship is historically established on the patient's autonomy, . . .