This project explores how different cultures and practices influence legislation, practical guidance and moral viewpoints on advance decision-making in England, France and Germany. For this purpose both theoretical approaches to advance decisions (AD) and concrete practices are analysed. In a first step, a literature based review is conducted in order to identify principal actors, their arguments and the influence they exert on the formulation of the questions regarding ADs in each country. In a second step, in order to get to know implementation of ADs and concrete experiences of situations, the project involves ethnographic observations of everyday life in hospitals and interviews with professionals considering problems associated with decisions to withdraw treatment in general and more specifically for patients who cannot express their will anymore. The observation of medical practices and interviews helps to identify gaps between practices and discourse and thus explore the value systems (and the normative preferences) of the actors with regard to concrete situations, but also cultural, legal, and historical contexts. Finally, the study aims to rethink theoretical concepts and define recommendations that are better suited to the reality in each country.
For more information on this research contact Dr Ruth Horn