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Expert makes case for Advance Directive in patients’ medical records

Prof. Bolatito Lanre-Abass of the Department of Philosophy, University of Ibadan, has advised Nigeria’s  health authorities to embrace Advance Directive  by including  it in  the medical records of patients.

Lanre-Abass, a member of the West African Bio-Ethics Training Programme, College of Medicine, University of Ibadan, gave the advice in an interview with newsmen in Ibadan.

The don, who  described  Advance Directive  as  “  a living will or advanced decision,’’ said  it is  “ a legal document in which a patient specifies what actions should be taken on his/her health if they are no longer able to make decisions for themselves because of illness or incapacity.’’

“In the US and other advanced countries, it has a legal status in itself  whereas in some countries it is legally persuasive,” she added.

According to her,  Advance Directive   is created in response to the increasing sophistication and prevalence of medical technology.

She said that numerous studies had  shown that there were critical deficits in the medical care of  persons with terminal conditions.

“It has been found to be unnecessarily prolonged, painful, expensive and emotionally burdensome to both patients and their families,’’ she said.

“Advance directives are  recognised in every state and millions of Americans have them as part of their medical records.

‘They are embraced by health care professionals, attorneys, hospice professionals and retiree organisations.

“The Nigerian health sector should embrace this system because our burden of adult mortality is still high in Nigeria.

“It should be included as part of medical records of patients in a hospital setting.

“Today there are so many options for people with life threatening illness, ranging from high-tech medical treatment to palliative care also known as comfort care.

“Through an Advance Directive, you are able to tell the doctors what you want or don’t want while you are yet able to do so.

“Having an Advance Directive usually means that you will avoid unnecessary pain, unhelpful procedures and unwanted hospitalisation,” she said.

The expert, who  further said that  patients could appoint a health care agent to make decisions for them, added:

“You can specify where you want to stay during your end of life  such as hospice or at home;  ask for spiritual care or allow visitors or limit them.

“All an Advance Directive needs to make it official is the signatures of two people who are not named in the document.

“The patient does not need an attorney or a notary. It should be given to your physician for inclusion in your medical record.

“And if you ever change your mind, you can revise it at anytime.’’



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