“预先指示”,或称为“生前预嘱”(livingwill),是由有决策能力的成年人(competentadults)就将来丧失能力(futureincapacity)时的若干决定提前表达自己的意愿。独立做出选择和决定的能力有可能受到精神疾病的影响,这就使得预先指示与精神卫生法产生了关联。精神健康领域的预先指示使有能力的自然人在遭遇精神健康危机之前得以明确自己对于治疗的某种倾向性。预先指示的提倡者认为它能够增进精神健康服务使用者的自主权,并且能够为精神疾病患者赋能,使其参与到未来的医疗决策之中。反对者则认为预先指示会引发一系列的法律与伦理问题,进而阻碍他们在实践中的工作。本文认为,由于预先指示在治疗效果、经济效益以及人权等方面都有潜在的益处,爱尔兰的精神健康领域应当给予预先指示足够的重视。
<<Advance directives or “living wills” are statements by competent adults setting out their wishes in anticipation of future incapacity to make decisions. The capacity to make independent choices and decisions may be impacted by mental illness,making advance directives of relevance to mental health law. Advance mental health directives allow competent individuals to specify their treatment preferences in advance of an incapacitating mental health crisis. Advocates believe that they can enhance autonomy and empower persons with mental illness to participate in their future treatment decisions. Opponents believe that they present a wide range of legal and ethical problems,making them unworkable in practice. The potential therapeutic,economic and human rights benefits demand their consideration in the Irish mental health context.
<<Keywords: | Advanced DirectiveInformed ConsentUN Convention on the Rights of Persons with Disabilities |