Value history jako instrument przedłużenia autonomicznego charakteru decyzji terapeutycznej poza moment utraty świadomości

Abstract

The concept underlying the institution of pro futuro declarations is the will to extend the possibility to determine one’s own fate beyond the moment of unconsciousness. Subsequent generations of such declarations have been the result of a search for solutions to adequately reflect the individual’s aspirations while at the same time securing their effective "enforcement". Currently, particularly within Anglo-Saxon legal culture, there is a growing interest in the institution of value history as an instrument providing justification for first- and second-generation anticipatory declarations by referring to the patient's hierarchy of values, worldview and beliefs. It is recognised, however, that such declarations make it possible not only to extend the patient's ability to determine his or her own future beyond the moment of unconsciousness, but also to attribute to such a disposition the qualities of an autonomous decision, i.e. one made by a competent person, freely exercised, informed and intentional. However, the possibility of exploiting the full potential of value history declarations is conditioned by the appropriate design of the form (in terms of both content and design) and an adequate information procedure that should precede the drafting of the declaration. Remarkably, the purely theoretical reflection that has been present since the 1980s regarding the desirable features of third-generation pro futuro declaration forms is now increasinglytaking the shape of considerations supported by consultations and research involving the participation of patients. Nevertheless, the fact that the institution of a living will or a power of attorney for health care has not yet been regulated at a statutory level in the domestic legalframework is a serious obstacle to the use of the possibilities offered by value history declarations within the Polish health care system.