8(G). Advance directives
Advance directives are mechanisms whereby an individual can articulate and formally record their wishes regarding treatment in advance. They are often completed between periods of crisis when the person is supported to reflect on their choices regarding treatment. In some countries, such as Switzerland, they are legally binding and can offer clear information to treatment teams regarding the will and preferences of the person, recognising the importance of informed consent and supported decision-making.
Advance directives are most useful when they provide options for treatment as well as practices to be avoided. Although uptake can be slow, they can prove to be beneficial in reducing coercion in individual cases and form part of an overall package to increase autonomy.90
90 JQ La Fond JQ and D. Srebnik, ‘The impact of mental health advance directives on patient perceptions of coercion in civil commitment and treatment decisions’. (International journal of law and psychiatry , 2002, 25(6), pp. 537-55); Susanne Brauer, Prof. Nicola Biller-Adorno and Dr. Roberto Adorno, Country Reports on Advance Directives, (Zurich: Institute of Biomedical Ethics, University of Zurch, 2008)