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Nursing Ethics
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Advance Directives: the New Zealand context

Pauline Wareham

Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand, pwareham{at}aut.ac.nz

Antoinette McCallin

Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand

Kate Diesfeld

Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand

Advance directives convey consumers’ wishes about accepting or refusing future treatment if they become incompetent. They are designed to communicate a competent consumer’s perspective regarding the preferred treatment, should the consumer later become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer’s competence and the document’s validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers’ and providers’ perspectives, and the medical and nursing positions in New Zealand.

Key Words: advance directive • competence • consumers’ choice • cultural sensitivity • New Zealand

Nursing Ethics, Vol. 12, No. 4, 349-359 (2005)
DOI: 10.1191/0969733005ne800oa
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