| Abstract |
The main issue at stake in the present dissertation is the statements of intent, namely Advance Directives, through which the consent or denial of a person to be subjected to a certain series of medical treatment at a future instance, during which he or she might have lost competence of apprehending or assessing his or her contemporary health status as well as of asserting his or her will, is regulatorily declared. In other words, Advance Directives pertain to the explicit and in black and white expression of one’s competent self’s preference of treatment regarding a future moment of incompetence of perception and self-expression, especially when it comes to painful operative treatments, cardio version, ceasing of mechanical support, etc., advance directives, shortly, regarding the cessation of a human life. The aim of this thesis is thus the reconstruction of the existing philosophical arguments regarding advance directives, while at the same time meeting the major dilemmas arising regarding this issue. In this course an effort to cite the foremost clashing contemporary philosophical arguments regarding Advance Directives will be embarked upon in what purports itself to be a well-argued and thorough attempt to reconstruct those arguments in direct correlation with the issues that reasonably arise when trying to elicit the interconnection between the principle of Advance Directives and Bioethics. Upon the one end of this line, Ronald Dworkin upholds the strict and inescapable enactment of Advanced Directives as they assertively endorse personal autonomy as the foremost tenet of integrity. On the other end, Rebecca Dresser, expert in biomedical ethics, on certain occasions rejects that very strict enactment of Advance Directives offering from a divergent conceptualization of the contemporary-to-his-malady condition of a dementia patient. According to Dresser, even within the severe stages of dementia a form of personal autonomy in the sense of self-assessment is sustained. In between this juxtaposition stands the intermediate argument of the philosopher Agnieszka Jaworska who reserves a place for the capacity of a dementia patient to attribute value to his very own life. One of the basic axis – beyond bibliography - upon which the extraction of the conclusions of the present essay is based in the current legal status circumscribing Advanced Directives both in our country and abroad. However it should be stated that the thesis pertains to patients of an incurable condition in a terminal stage or of an advanced stage of dementia or Alzheimer's disease. In this course, the main legal texts concerning Advance Directives, the most indicative of which being the International Convention of Oviedo and the Greek Code of Medical Ethics, will be cited. It should be noted that some European countries, such as Austria, the Netherlands, Belgium as well as the USA (e.g. California, Texas) have already accordingly legislated, whereas others including Greece have not. By 1992 all 50 states had passed some legislation on advance directives. In the final part concluding reflections regarding the notions of personal autonomy, human dignity and human will be presented, taking into account the current conditions and the individual characteristics of Greek society in an attempt to contribute as vividly as possible to a lively and open debate based upon reliable judgment and sound reasoning.
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