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葡萄牙国家生命科学伦理委员会2005年发布了关于持续性植物状态(PVS)和拒绝输血的两个重要意见。第一个意见主张应当尊重预先指示;但是,第二个意见认为预先指示“仅具有参考性”。国家伦理委员会的不同意见反映了解决这一问题的难度。葡萄牙批准了《人权和生物医学公约》,该公约规定“应当考虑”预先指示(第9条)。为了规范这一通用法则,葡萄牙生物伦理协会向议会提出了一项法律草案,旨在推进预先指示合法化(包括“生前遗嘱”和“医疗护理委托书”)并建立预先指示的国家登记制度。这一提案明确提出预先指示应当具有约束力。但是,关于生前遗嘱生效程序的一些法规值得进一步讨论。作者赞同在预先指示有约束力的情况下采取预先的医疗面谈和庄严的仪式,以确保拒绝治疗的自由和知情。
In 2005, the Portuguese National Council for Life Science Ethics issued two important observations on Persistent Plant Status (PVS) and refusal of blood transfusion. The first opinion advocates respect for advance directives; however, the second opinion is prescriptive “solely for reference.” The different opinions of national ethics committees reflect the difficulty of resolving this issue. Portugal ratified the Human Rights and Biomedicine Convention, which stipulates that “it is appropriate to consider” the advance directive (Article 9). In order to regulate this general rule, the Portuguese Society of Bioethics proposed a draft law to parliament to advance the legalization of advance directives (including “living wills” and “medical care proxy letters”) and to establish advance directives National registration system. This proposal clearly states that advance directives should be binding. However, some statutes regarding the procedure for the taking of living will deserve further discussion. The authors agree to take advance medical interviews and solemn ceremonies with pre-directive binding to ensure the refusal of treatment and freedom of information.