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The living will or advanced directives. Medicolegal considerations and analysis of the status of implementation in Spain
El testamento vital o documento de voluntades anticipadas. Consideraciones m??dico-legales y an??lisis de la situaci??n de implantaci??n en Espa??a
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Josep Arimany-Mansoa,b,
Corresponding author
josep.arimany@comb.cat

Corrosponding author.
, Laura Aragon??s-Rodr??gueza, Esperanza-L. G??mez-Dur??na,c, Emma Galcer??na, Carles Martin-Fumad??c,d, Francesc Torralba-Rossell??e
a Servicio de Responsabilidad Profesional, Colegio Oficial de M??dicos de Barcelona, Barcelona, Spain
b Unidad de Medicina Legal y Toxicolog??a, Departamento de Salud P??blica, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
c Departamento de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
d Institut de Medicina Legal i Ci??ncies Forenses de Catalunya, Barcelona, Spain
e Universitat Ramon Llull, Barcelona, Spain
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Tables (3)
Table 1. Different names, according to the autonomous communities.
Table 2. Declarants with an active advance directive by AC in 2015, per 1000 inhabitants.
Table 3. Declarants with an active advance directive by age group in 2015.
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Abstract

The social significance of the rights of patients has produced in Spain a diffuse legislative enactment since 2000 that culminated with the drafting of the living will document, or advanced directives. The basis of this document is the recognition of the autonomy of the patient. This respect goes beyond the competencies of the patient by enabling clinical situations to be anticipated and related decisions to be taken in advance.

Living will is a written document that reflects an act of personal responsibility. It is a tool for making clinical decisions that is particularly applicable to chronic patients susceptible of developing cognitive impairment and a state of dependency. Health professionals should be aware of current legislation on the principle of autonomy, and must make their patients aware of the option to implement this procedure. An educational and public awareness campaign aimed at professionals and the general public is required.

Keywords:
Advanced directives document
Living will
Advanced directives
Informed consent
Bioethics
Advance directives record
Principle of autonomy
Resumen

La trascendencia social de los derechos de los pacientes ha comportado en España una prolija promulgación legislativa desde el año 2000, que culmina con el desarrollo del documento conocido como testamento vital, de instrucciones previas o de voluntades anticipadas. El fundamento del testamento vital radica en el reconocimiento de la autonomía del paciente. Este respeto va más allá de la situación de competencia del paciente al permitir anticipar situaciones clínicas y sus correspondientes decisiones. El documento de voluntades anticipadas es un documento escrito que refleja un acto de responsabilidad personal, siendo de especial ayuda en enfermos crónicos que pueden evolucionar hacia situaciones de dependencia y deterioro cognitivo. Los profesionales de la salud deben conocer la legislación vigente en materia del principio de autonomía. Resulta esencial que den a conocer a sus pacientes la posibilidad de realizar este procedimiento. Es necesaria una tarea divulgativa y pedagógica ante los profesionales y la población general.

Palabras clave:
Documento de voluntades anticipadas
Testamento vital
Instrucciones previas
Consentimiento informado
Bio??tica
Registro de voluntades anticipadas
Principio de autonom??a

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