APPLICATION OF ADVANCE DIRECTIVES IN PATIENTS WITH INTELLECTUAL DISABILITIES

Abstract

Advance Directives (ADs) represent a fundamental ethical and legal instrument to ensure the autonomy of patients with intellectual disabilities in health decisions. However, their application in people with intellectual disabilities is still permeated by practical, ethical, and legal barriers. The objective of this study was to analyze, through a systematic literature review, the main challenges in the application of ADs in patients with intellectual disabilities. The search was conducted in the PubMed, SciELO, BVS, and Google Scholar databases, encompassing articles between 2012 and 2025. Studies in Portuguese and English that addressed ADs in patients with intellectual disabilities were included. Of the 68 articles identified, 22 met the inclusion criteria. The results highlight three central axes: 1) practical difficulties in culture and communication; 2) the need to use ADs adapted to individuals with disabilities; 3) the adoption of Advance Care Planning (ACP) to promote early dialogue, according to international experience. It is concluded that the effectiveness of advanced driving techniques (ADs) for people with intellectual disabilities depends on cultural change, professional training, adoption of the Pacing Action Plan (PAC), and the use of specific protocols adapted to the Brazilian health system.

DOI: https://doi.org/10.56238/sevened2025.037-053