• 作者：J. Zabala Blanco^a ; ^{jaime.zabala@unican.es} ; J.F. Dí ; az Ruiz^b
• 关键词：Instrucciones previas ; Testamentos vitales ; Bioé ; tica ; Autonomí ; a
• 刊名：SEMERGEN - Medicina de Familia
• 出版年：2010
• 出版时间：May 2010
• 年：2010
• 卷：36
• 期：5
• 页码：266-272
• 全文大小：194 K

In our country, there has been a gradual recognition of patients?rights and their decision autonomy, which has leading to take the form of advance directives through the State Law 41/2002 and the different laws of the Autonomous Regions. But we must emphasize the differences between them.

The development and the implementation of the advance directives, as any other innovation, should be carefully planned. If it is not done properly or it is done precipitately, it will not be understood neither the clients/patients nor the health professionals.

When the advance directives are considered as a process but not just as a simple document; as part of the ethic in the clinic relationship but not as a legal approach, they will became a key factor in the relationship between health professionals and clients/patients.

But we are at the risk to face with the documents of advance directives in the same way what has happened, in some cases, with the informed consent. They can be considered as mere signing documents, without a real value and converting them into simple acts of ¡°defensive medicine? And they can be considered, mainly, by groups that think their values and believes can be at risk when the health care is delivered.

Administratively highly purified documents will not be useful if the process does not meet the following characteristics: clearness (anyone involved in the process must understand what they are and what they are for), simplicity (establishing easy procedures to be carried out and to be recordered) and usefulness (if necessary, their use have to respond to the legitimate expectations of the grantor).