Consultation Paper on Bioethics: Advance Care Directives

Tuesday, 14th October 2008 | 0 comments
Filed under: 2008.


Tuesday 14th October 2008:  The Law Reform Commission’s Annual Conference 2008, Bioethics: Advance Care Directives, will be opened by Minister of State at the Department of Health and Children, Máire Hoctor, TD, in Dublin Castle this morning.  The Conference will begin at 9.30 am.

Advance care directives: written and verbal
An advance care directive sets out a person’s wishes about what should happen to them in the event of an incapacitating accident (such as a serious car crash) or illness (such as stroke or the onset of Alzheimer’s disease) that makes it impossible for them to communicate their wishes directly.  An advance care directive can be written or verbal and, quite often, the person will also nominate another person to carry out their wishes; this other person is sometimes called a health care proxy.

Launch of Commission’s Consultation Paper
At the Conference, Minister of State Hoctor will also launch the Commission’s Consultation Paper on Bioethics: Advance Care Directives, which forms part of the Commission’s Third Programme of Law Reform 2008-2014.  The Consultation Paper provisionally recommends that there is a need for legislation to cater for people who make advance care directives, whether verbally or in writing, and it makes 25 specific recommendations on the topic.  Commissioner Patricia Rickard-Clarke will outline to the Conference the Commission’s main recommendations.

Main recommendations
The main recommendations in the Consultation Paper are that:

  • The proposed legislation would not involve euthanasia, assisted suicide or allow a person to refuse basic care
  • The proposed legislation would deal only with advance care directives involving refusal of treatment, for example: “I do not wish to receive a flu injection” or “I do not wish to be resuscitated.” It would not deal with requests for treatment, for example: “I want a liver transplant.”
  • An advance care directive could, in general, be written or verbal but one that refuses life-sustaining treatment would have to be in writing
  • The proposed legislation could, in general, allow a person to refuse treatment on religious grounds
  • The proposed legislation should allow for the nomination of a healthcare proxy to carry out the person’s wishes
  • A person should be encouraged to seek medical advice when making an advance care directive, but it should only be mandatory in the case of directives involving the refusal of life-sustaining treatment
  • An advance care directive would only become effective where the person becomes incapacitated and the directive deals with the condition mentioned in it
  • A healthcare professional would not have any legal liability where they follow an advance care directive that they believe to be valid and applicable to the condition being treated
  • A set of guidelines for the health professions should be drawn up to complement the proposed legislation.

The Conference: legal and ethical issues concerning advance care directives
The Conference focuses on the legal and ethical issues surrounding advance care directives, and this also launches the Commission’s public consultation on this important topic. The Conference speakers include:
• Dr Katherine Froggatt (Institute of Health Research, Lancaster University, England)
• Dr Mary Keys (School of Law, NUI Galway)
• Dr Doiminic Ó Brannagáin (Consultant Physician in Palliative Medicine)
• Prof David Smith (Irish Council for Bioethics) and
• Mr Mervyn Taylor (Hospice Friendly Hospitals).