Abstract
Background This article aims to address questions related to the protection of rights of holders of compromised decisional competence, to make decisions, especially for its condition of vulnerability in relation to the other members of the human community to which they belong to, in access to the preservation of their dignity.
 Methods and Findings Although Bioethics has been increasingly evolving in plural and secular democratic societies, gaps and conflicts deserve a special reflection which can result in new paths and solutions for those with limitations in their abilities of understanding and determine according to this understanding, making decisions that may not translate a reflected decision about the health care they can undergo, as well as participation in scientific research and other issues involving their health and their bodies.
 Conclusions This work recommends a greater appreciation of patient autonomy, as well as embracing the Advance Directive of Will in the western world, with some limitations encountered, and some suggestions offered.
Highlights
Society has been accompanying a profound change in medicine, which, with technological advances that are increasingly effective, keep patients with chronic diseases with an increasingly long life, not Keywords Bioethics; Advance Directives of Will; Incompetent
According to Bravo G, Rodrigues C, Theriaul V, Arcaud M, Downie J, Dubois M et al (2017), in the first article that returned in the research, the concern would be answering if medical assistance in death should be extended to incompetent patients with dementia [3]
Dementia is reported to affect more than 37 million people worldwide, with a forecast of growing to more than 115 million by 2050
Summary
Associated with this condition, it is notorious that there is a paternalistic functioning of Medicine in some aspects, which in the Code of Medical Ethics [1], in article 32, it says "It is forbidden for the physician to cease using all available diagnostic and treatment methods, scientifically recognized and within their reach, in favor of the patient." The article, when interpreted, disconnected from the others, keeps the doctor as the sole holder of the ability to decide, when choosing a treatment for any patient.
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