Article 450 of the Medical Treatment Contracts Act (WGBO) of 1994 contains a paragraph which can be interpreted as referring to advance directives. It is stated therein that if a patient aged 16 or over cannot be deemed capable of reasonably assessing his/her interests with regard to care, the care provider shall comply with the apparent opinion of the patient expressed in writing while he/she was still capable of reasonable assessment.

Conditions surrounding the writing, validity and registering of an advance directive

As stated above, to make a valid advance directive, a person must be aged 16 or over and have the necessary capacity to do so.

What an advance directive can cover

It is not stated what an advance directive can and cannot cover.

Obligation to comply with instructions contained in an advance directive

Care providers are not legally bound by advance directives and may deviate from them if there are good reasons for doing so. In a fact sheet produced by the Ministry of Health, Welfare and Sport (1995), it is stated that care providers are not obliged to search for such statements in emergency situations and that in any case, advance directives must be clear and have been made fairly recently.

The Termination of Life on Request and Assisted Suicide (Review Procedures) Act of 2002 contains provisions on advance directives relating to euthanasia. Such a directive may be regarded as a request for euthanasia by the patient if he/she becomes unable to express his/her will. Physicians are not required to perform euthanasia but those physicians who are willing to do so must regard an advance directive as an expression of the will of the patient (Council of Europe, 2003). However, Wortmann (2004) has suggested that an advance directive cannot be used to request active voluntary euthanasia in the case of patients with dementia as the request must have been expressed continuously and steadfastly by the patient over a long period of time.

Amending, renewing and cancelling advance directives

Patients may retract or modify an advance directive at any time.