Acknowledgement, therefore, of the possibility of enhancing the value of the system of support administration by means of a mechanism based on a prior nomination in terms of the implementation of earlier decisions regarding treatment, does not exclude the fact that it is preferable to lay down a systematic discipline on the subject which guarantees full implementation of the principle of self-determination in the field of health care, particularly in the light of the imperfect overlap between the institution in question and the so-called living will. For some authors,18 even the need for the directives and for the designation of a fiduciary to be conveyed in a notarial act or in a stronger form seems inappropriate: the absence of directives regarding property and assets, the connection with the sphere of very personal rights and the fact that the directives can be revoked or modified at any time result surely in unfair burdensome formalities, making it seem preferable that these directives are grouped in an original and signed statement or declared by word of mouth to the health care staff and put in writing by them. An ad hoc regulatory framework, as wished for by many, for advance health care directives, may therefore take its place in the legal system, while being assimilated within existing principles, regulations and institutions, and providing an element of certainty for the healthcare staff involved as well as a certified guarantee of the wishes of the individual concerned