The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking
Abstract 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 to...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-02-01
|
| Series: | Research in Health Services & Regions |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s43999-025-00060-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823863252113686528 |
|---|---|
| author | Elisabeth Stock Christian H. Nickel Bernice S. Elger Andrea Martani |
| author_facet | Elisabeth Stock Christian H. Nickel Bernice S. Elger Andrea Martani |
| author_sort | Elisabeth Stock |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-20e7a86eebec4e88a8a1c69f2156887a |
| institution | Kabale University |
| issn | 2730-9827 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
| record_format | Article |
| series | Research in Health Services & Regions |
| spelling | doaj-art-20e7a86eebec4e88a8a1c69f2156887a2025-02-09T12:12:53ZengSpringerResearch in Health Services & Regions2730-98272025-02-01411910.1007/s43999-025-00060-6The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymakingElisabeth Stock0Christian H. Nickel1Bernice S. Elger2Andrea Martani3Institute for Biomedical Ethics, University of BaselEmergency Center, University Hospital BaselInstitute for Biomedical Ethics, University of BaselInstitute for Biomedical Ethics, University of BaselAbstract 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.https://doi.org/10.1007/s43999-025-00060-6Advance DirectivesAdvance Care PlanningResource allocationCOVID-19 pandemicInstrumental value |
| spellingShingle | Elisabeth Stock Christian H. Nickel Bernice S. Elger Andrea Martani The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking Research in Health Services & Regions Advance Directives Advance Care Planning Resource allocation COVID-19 pandemic Instrumental value |
| title | The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking |
| title_full | The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking |
| title_fullStr | The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking |
| title_full_unstemmed | The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking |
| title_short | The instrumental value of advance directives: lesson learned from the COVID-19 pandemic for policymaking |
| title_sort | instrumental value of advance directives lesson learned from the covid 19 pandemic for policymaking |
| topic | Advance Directives Advance Care Planning Resource allocation COVID-19 pandemic Instrumental value |
| url | https://doi.org/10.1007/s43999-025-00060-6 |
| work_keys_str_mv | AT elisabethstock theinstrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT christianhnickel theinstrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT berniceselger theinstrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT andreamartani theinstrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT elisabethstock instrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT christianhnickel instrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT berniceselger instrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking AT andreamartani instrumentalvalueofadvancedirectiveslessonlearnedfromthecovid19pandemicforpolicymaking |