NURE Investigación (May 2004)
From Advance Directives or Living Wills to Advance Care Planning
Abstract
Since 2000 a great amount of legal norms about advance directives documents has been developed in Spain. In this topic the experience of countries as USA and Canada is much longer, starting in the 60´s. It is important to learn pros and cons about advance directives that North American countries have discovered in this long time. With this objective, we review in this paper the evolution of the living wills documents, the impact of the Patient Self - Determination Act and the influence of the SUPPORT study. In addition we review the Advance Care Planning, the current orientation (since 1995) of the advance directives, and the role of qualitative investigation in its implementation. Finally, the state of the art in Spain and some proposals for the implementation of Advance Care Planning in our country, are outlined.