Keywords
respect
living wills
hospice care.
Abstract
Advance care planning by means of the so-called advance directives is a tool that allows patients to express, either orally or in writing, their preferences, values and goals in regarding the treatments they wish or do not wish to receive in the future, in the event of losing the capacity to communicate them themselves. It is a key mechanism to ensure respect for the autonomy of patients who find themselves in a clinical situation that makes it impossible for them to communicate. Although it represents an essential strategy for the humanization of end-of-life care, its integration into clinical practice remains uncertain. Therefore, there is a need to explore its implementation from primary care to the hospital settings, which could improve quality of life, reduce uncertainty and strengthen the bond between patients and health care professionals. This article provides a narrative review of the conceptual, regulatory, clinical and ethical foundations of advance directives, with an emphasis on their applicability in the Colombian context. To this end, a search was conducted into the current literature available on advanced care planning, advanced directives, palliative care, and end-of-life decision-making in the MedLine (PubMed), Lilacs, and Science Direct databases, from which 30 articles were included. The results showed that, although advance directives have been shown to contribute to comprehensive medical care and improve the quality of life of patients and their families, there are significant barriers to their implementation. Finally, it was concluded that advanced directives are an essential tool for promoting ethical, individualized, and respectful end-of-life care, and that strengthening them requires the training of health professionals, as well as public policies that facilitate their access and effective application.References
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