End of life, language, and the press

By Cristiane Avancini Alves

In my previous post, I mentioned that Brazil does not have a specific law about advance directives. Nevertheless, a recent Resolution of the Federal Board of Medicine addresses this subject. It indicates that so-called “advance directives of will” are the set of desires, previously and expressly manifested by the patient, about the treatment he wants (or does not want) to receive when he is unable to express his will in a free and autonomous manner. Two points must be highlighted: the physician will not follow any patient’s directive that could violate the Medical Ethical Code, and the patient’s wish will overrule the intervention of his family regarding his decision.

The Resolution clearly expresses that “advance directives of will” mean what the phrase itself indicates: a direction, not a closed document that cannot be modified or that must be blindly followed. Time is significant in this context. For example, rapid biomedical development and the new possibility of cure can change the patient’s treatment course, regardless of a prior directive. Besides that, our personal believes about life and death can also change. Unfortunately, these elements have been misrepresented by the media. One of the most important Brazilian magazines dedicated a special report to the subject, but the headline was: “I decide my end”. No. That’s not what the Resolution affirms. The report continues by saying that the expression “advance directives of will” is a “pompous” name for “vital testament”. No. The title is not pompous, but rather accurate – reflecting simply that the document is a previous direction made by the patient. Moreover, advance directives of will cannot be related to testament, since the directive’s effects will occur during life, not after it – as it is for the legal meaning for testament.

Overall, the issues that came up here are indicative of broader issues related to how the media and public understand their rights, and the importance of word choice and clarity to that understanding.

    Comments are closed.