The Purpose of Advance Medical Planning — Autonomy for Patients or Limitation of Care?

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Abstract
Methods for advance medical planning were originally developed to ensure that patients' preferences would guide the nature and intensity of their future medical care. Increasingly, however, advance planning is viewed as a tool to limit care. For example, a study of the effects of advance directives on medical treatments and costs was performed, the authors said, with the “hope that executing the California Durable Power of Attorney for Health Care might provide a more ethical approach to reducing health care costs.”1 Even when the purpose is not cost containment, there may be a philosophical emphasis on limiting, rather than maintaining, . . .