There would have to be a clearly identifiable 'trigger event' - either the onset of incompetence or the occurrence of another event in the already incompetent. No-one signing an Advance Directive while well could possibly foresee all future situations or ways in which new medical treatments could affect those situations in years to come. This is probably the biggest single problem. The healthy do not choose in the same way as the sick. When we become unwell our attitudes to what we want change.
Doctors do get it wrong sometimes.
Effect on the Disadvantaged. The fear which drives many to sign Advance Directives is of losing control, and becoming a member of a disadvantaged group such as the severely disabled, the confused elderly or the terminally ill. However, these are the very groups whose treatment needs a positive approe group promoting them. The British Medical Association is in favour of the principle of Advance Directives as pieces of paper but is fiy in their own treatment, but they also reflect a lack of trust in doctors. Andrew Fergusson is General Secretary of CMF and Chairman of HOPE, Healthcare Opposed to Euthanasia.