Abstract
How ought we respond to advance directives that appear to fly in the face of a severely mentally impaired patient's quality of life? An advance directive is a legal instrument wherein a person records instructions regarding the medical treatment that she is to receive in the event that she becomes persistently incapable of refusing or giving informed consent to treatment. Where these instructions are legally binding, they enable a person to exercise control over her future medical treatment. This has been welcomed by some on the grounds that it increases patient autonomy, but there has also been concern that in cases in which a patient is left conscious but severely mentally impaired, the person's advance ..