Medicine and the Law

Advance directives

Medicine and the Law

Advance directives

Josephine Inge, Paul Nisselle

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Abstract

A patient with HIV signs an advance directive refusing resuscitation or admission into intensive care. Early in the course of the disease, the patient suffers an anaphylactic reaction to a drug. What do you do?

Article Extract

This scenario was posed in a paper published in the MJA (2000; 172: 545-548). What should be done when an advance directive rules out treatment that is in the patient’s best interests? If the directive is valid, treatment may constitute battery. If the directive is legally invalid, withholding treatment may amount to a breach of the duty of care.