Weill Medical College of Cornell University

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Advance Directives

• Advance Directives
• End-of-Life Care
• Ethics and the Biomedical Sciences
• Neuroethics

Dr. Fins led a team of researchers in studying the role of advanced directives and how patients and proxies understand their moral obligations to each other. A “proxy” is someone to whom patients grant legal power-of-attorney should they become incapable of making medical decisions for themselves. The results, which were published in the January 2005 issue of the Journal of Pain and Symptom Management, suggested that the pact between patients and their proxies is much deeper and more flexible than previously thought. "It appears that it's not so much a contract as it is a kind of covenant, based on mutual experience and trust. And our study found that, because of this trust, patients allow proxies discretionary moral judgment that allows them to go beyond cryptic instructions to either withhold or provide care," said Dr. Fins. Read the press release on this study.

Their work also led to the publication of an advance care workbook for patients and proxies, called "Fidelity, Wisdom, and Love."