Using the family covenant in planning end-of-life care: Obligations and promises of patients, families, and physicians
| Abstract | Physicians and families need to interact more meaningfully to clarify the values and preferences at stake in advance care planning. The current use of advance directives fails to respect patient autonomy. This paper proposes using the family covenant as a preventive ethics process designed to improve end-of-life planning by incorporating other family members—as agreed to by the patient and those family members—into the medical care dialogue. The family covenant formulates advance directives in conversation with family members and with the assistance of a physician, thereby making advance directives more acceptable to the family, and more intelligible to other physicians. It adds the moral force of a promise to the obligation of respecting a patient’s preferences about end-of-life care. These negotiations between patient, family, and physician, from early planning phases through implementation, should greatly reduce the incidence of family disagreements on what the patient would have wanted. The family covenant ensures advance directive discussions within the family, promotes and respects the autonomy of other family members, and might even spur others in the family to complete advance directives through additional covenants. The family covenant holds the potential to transform moral quagmires into meaningful moral conversation. J Am Geriatr Soc 51:1155–1158, 2003. | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| Options |
|
|||||||||
| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,631 |
| External links |
|
| Through your library | Only published papers are available at libraries |
Ray Moseley (2001). Family Physicians and the Family Covenant Model's Usefulness in Solving Genetic Testing Conflicts. American Journal of Bioethics 1 (3):28-29.
Ronald J. Christie (1986). Ethical Issues in Family Medicine. Oxford University Press.
Lawrence J. Schneiderman (1995). When Families Request That 'Everything Possible' Be Done. Journal of Medicine and Philosophy 20 (2).
Eugene V. Boisaubin (2004). Observations of Physician, Patient and Family Perceptions of Informed Consent in Houston, Texas. Journal of Medicine and Philosophy 29 (2):225 – 236.
Benjamin H. Levi & Michael J. Green (2010). Too Soon to Give Up: Re-Examining the Value of Advance Directives. American Journal of Bioethics 10 (4):3 – 22.
Renate G. Justin (1987). The Value History: A Necessary Family Document. Theoretical Medicine and Bioethics 8 (3).
Barry Hoffmaster & Wayne Weston (1987). The Patient in the Family and the Family in the Patient. Theoretical Medicine and Bioethics 8 (3).
David J. Doukas & Jessica W. Berg (2001). The Family Covenant and Genetic Testing. American Journal of Bioethics 1 (3):2 – 10.
J. Vollmann (2001). Advance Directives in Patients with Alzheimer's Disease; Ethical and Clinical Considerations. Medicine, Health Care and Philosophy 4 (2):161-167.
Monthly downloads |
Added to index2009-01-28Total downloads21 ( #58,633 of 548,974 )Recent downloads (6 months)1 ( #63,511 of 548,974 )How can I increase my downloads? |

