From bioethics to human rights: a European study on advance health care directives

Abstract

This dissertation looks at the scientific field of Bioethics from a juridical perspective, in the context of the development of the so-called third generation of human rights, and it examines current legal instruments in human rights law in the light of biomedical principles. The main purpose is to evaluate advance directives as legal instruments for the exercise of prospective autonomy and making individual choices close to the end of life. I will also analyse the origin of the advance health care directives in the light of changes in death perspectives in contemporary societies and consequent proliferation of advance directives laws in Europe. Accordingly, the various types will be defined and assessed from ethical, medical and religious perspectives. In the light of legislative developments in patients’ rights in Europe, and the consolidation of the doctrine of informed consent, this work makes a juridical comparative study between three countries: the Netherlands, Spain, and Portugal. The aim is to ascertain if these legal instruments merely exist in theory or if they are effectively being put in to practice, and analyzes their strengths and weaknesses. The dissertation poses the question whether there is a need and if it is feasible, for a more substantive regional consensus on this matter and offers some proposals for a better advance care planning, in order to promote the patient’s self-determination.