HETERO- / AUTONOMY IN THE CONTEXT OF SELF/DETERMINISM OF BIOLOGICAL TESTAMENTS

Abstract

A contemporary view of death is characterized by a sequence of uncertain and difficult questions arising from the clinical context, out of the legal and bioethical domains of taking difficult existential decisions related to the last moments of human life. This step requires a full rationality of free autonomy, which can be significantly disturbed by the loss of mental ability, conditioned by certain illnesses in certain moments. Therefore, patients should have a legislative opportunity to clearly state their wishes regarding the required treatment or the withdrawal in previously prepared guidelines of anticipated medical dispositions of the biological testaments for (non) treatment or the appointment of a surrogate representative of treatment choice at the terminal phase, in case of limited decision-making ability. The signed biological will could greatly contribute to a dignified mode of dying, consistent with the choice of autonomous patient’s end-of-life care values, which can often enter into collision from a heteronomous perspective of a surrogate decision-maker. With the biological will we could overwhelmingly overcome the difficulties of the clinical dilemma of existential decisions: Physicians would be more reliant on choosing care in urgent health care plans in crisis situations, the patients could provide the assurance of their self-determination while the surrogate rulers could be largely released from the pressure of responsibility.