Bioethics: What Everyone Needs to Know ®

by Bonnie Steinbock

ADs, however, have the same moral force. Their strength varies with a number of factors. It is greater (1) when they are based on realistic assessment of the facts. People who write an AD wishing to avoid living years into severe dementia, for example, must inform themselves about the various stages of dementia and what life may then be like. They need to know that they might turn out to be relatively contented, though they could also be terribly frightened, anxious, and confused. Directives’ force is also greater (2) when they reflect the person’s enduring values, and those values are mentioned or even briefly explained. An AD’s weight is greater (3) when the directive is clear about what should be withheld and when, and (4) when they have been written, revised, or reiterated relatively recently, not only decades ago.