Advance Directives and Surrogate Decision Making in Health Care

Advance directives determine the care of terminally ill patients. Writing them can be a difficult and ethically controversial process on which opinions vary culturally. In this text the contributors examine the controversy surrounding the directives in three countries: the USA, Germany, and Japan.

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Advance directives to determine the care of terminally ill patients have revolutionized health care decision making. But writing a directive which accomplishes exactly what a patient wants can be a difficult process and can be ethically controversial. While Americans, deeply immersed in Western liberal poltical philosophy have an intuitive attraction to advance directives, other cultures do not. In this volume, an international team of experts examines the controversy surrounding advance directives in three countries: the USA, Germany, and Japan. Within each section, the subjects are addressed from the clinician's, legal expert's and bioethicist's points of view. The authors find that the USA and Japan are at opposite ends of a spectrum of opinion regarding patient autonomy, whereas Germany falls somewhere in between.