The aim of this guideline is to inform health and social care professionals on how best to manage advance care planning (ACP) in clinical practice. At the core of current health and social care are efforts to maximise individuals’ autonomy, promote patient-centred care, offer choice and the right to decide one’s own treatment or care. This can be difficult to achieve when an individual has lost capacity – the ability to make their own, informed decision. ACP is one method of enhancing autonomy, not only where an individual has lost capacity, but also by focussing discussion on the individual’s values and preferences throughout the time they are in contact with health or social care professionals. Whilst ACP has been used for some time in North America, there has been relatively little experience in the use of ACP in the UK. This set of concise evidence-based guidelines has therefore been prepared to guide practitioners.
This End of life guidance covers three main issues: contemporaneous and advance refusal of treatment; withholding and withdrawing life-prolonging medical treatment; assisted dying - euthanasia and assisted suicide.
The present paper constitutes the input of Alzheimer Europe and its member organisations to the ongoing discussions within Europe about advance directives (in the context of Alzheimer’s disease and other forms of dementia). It is the result of discussions carried out in a multidisciplinary group, comprising experts in the field of psychiatry, neurology, pharmacology, psychology, law and ethics, in collaboration with the Board of Alzheimer Europe and its member associations. Please see Annex 1 for the list of participants of the working group. Alzheimer Europe’s position on advance directives was guided by several general principles and was influenced by principles contained in pre-existing European or international documents. Please refer to section D for details. On the basis of these principles and of a review of current literature concerning issues linked to the use of advance directives, Alzheimer Europe has developed the following position with regard to advance directives.
Rechtsonzekerheid voor artsen bij uitvoering euthanasie onacceptabel Artsen houden zich goed aan de euthanasiewet, zo blijkt uit de tweede evaluatie van deze wet. Maar zij worden geconfronteerd met rechtsonzekerheid over het toetsingskader. Daarom steunt de KNMG de aanbeveling van een code of practice voor de toetsingscommissies en dringt zij aan op duidelijkheid over de waarde van de schriftelijke wilsverklaring bij wilsonbekwame patiënten. De KNMG reageert hiermee op de tweede evaluatie van de Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding (Wtl).