Adherence to advance directives

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7428.1407 (Published 11 December 2003) Cite this as: BMJ 2003;327:1407

Maybe doctors do not always know best

  1. Philip S Jones (psjones{at}doctors.org.uk), specialist registrar in anaesthetics
  1. Homerton Hospital, London E9 6SR

    EDITOR—The study by Thompson et al was a timely examination of health professionals' attitudes when the wishes of patients do not match their own.1 Even after the recent judgment in the case of Miss B it seems that many of us are simply not prepared to allow patients to refuse treatment they do not want.

    In the case described by Thompson et al the competently expressed wish of the patient may be disregarded only if there is evidence that her wishes have changed since the directive was signed. If not, once practitioners are satisfied that the clinical circumstances match those for which the directive provides (and this is moot), then there is no moral, ethical, or legal basis for disregarding her wishes.

    Do we need further lawsuits before we collectively accept that our role should not include a paternalistic contempt for what our patients want?


    • Competing interests None declared.


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