Primenjivost anticipirane naredbe pacijenta i promenjene okolnosti

Abstract

The subject of this paper is the overview of what constitutes meeting one of the requirements for exercising the patient’s advance directive - its applicability in relation to the proposed medical treatment, as well as the overview how the change of circumstances can impact its effect. The author of this paper finds that the clarification and concretization of a medical treatment which a patient may or may not accept in advance is the key prerequisite of its future applicability and of consistent respecting of the individual's autonomy and his right to self-determination. The author advocates the appreciation of the impact which the change of cisrcumstances may have on valid advance directives and raises some significant issues related to this topic: what is a relevant time frame for taking into account their effect, what kind of change of circumstances can lead to not respecting the patient's directive, how to proceed when the wish of the patient incapable of giving an informed consent is different from his will expressed in the advance directive, what is the significance of including the third person who will on behalf of the patient communicate with the doctor in relation to the application of the advance directive. In the concluding remarks the author states that the susceptibility of patients' advance directives to the influence of changed circumstances reflects on their binding nature and that this mechanism of decision making plays a restrictive role in the treatment of the patients incapable of giving an informed consent.