The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking

Open conversations between patients and healthcare professionals (HCP) are required to evaluate which treatments are reasonable for the individual case, especially towards the end of life. Advance Care Planning (ACP), which often results in drafting an Advance Directive (AD), is a useful tool to hel...

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Veröffentlicht in:Research in Health Services & Regions Jg. 4; H. 1; S. 1 - 9
Hauptverfasser: Stock, Elisabeth, Nickel, Christian H., Elger, Bernice S., Martani, Andrea
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 05.02.2025
Springer
Schlagworte:
Advance Care Planning
Advance Directives
COVID-19 pandemic
Health Administration
Health Promotion and Disease Prevention
Health Sciences
Health Services Research
Instrumental value
Medical Geography
Medicine
Medicine & Public Health
Original Paper
Resource allocation
Statistics for Life Sciences
Advance Care Planning
COVID-19 pandemic
Instrumental value
Advance Directives
Resource allocation
ISSN:2730-9827, 2730-9827
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Zusammenfassung:Open conversations between patients and healthcare professionals (HCP) are required to evaluate which treatments are reasonable for the individual case, especially towards the end of life. Advance Care Planning (ACP), which often results in drafting an Advance Directive (AD), is a useful tool to help with decisions in these circumstances, but the rate of AD completion remains low. During the COVID-19 pandemic, ACP and AD gained popularity due to the alleged advantage that they could facilitate resource allocation, to the benefit of public health. In this article, which presents a theoretical reflection grounded in scientific evidence, we underline an even stronger ethical argument to support the implementation of AD in end-of-life care (eol-C) i.e. the instrumental value at the individual level. We show, with particular reference to lessons learned from the COVID-19 pandemic, that AD are instrumentally valuable in that they: (1) allow to thematise death; (2) ensure that overtreatment is avoided; (3) enable to better respect the wish of people to die at their preferred place; (4) help revive the “lost skill” of prognostication. We thus conclude that these arguments speak for promoting the territorially uniform implementation and accessibility of high-quality AD in care.
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ISSN:2730-9827
2730-9827
DOI:10.1007/s43999-025-00060-6