The Advanced Healthcare Decisions Bill which was published in January 2012 will, if passed, allow individuals aged over 18 and who have capacity, to record their wishes concerning future health care decisions for reference at a date when they no longer have capacity.

An advance healthcare decision (or ‘living will’ as it is commonly referred to in other jurisdictions), once validly executed, would have the same force and effect as refusal of treatment by an individual who has capacity and should be respected by medical practitioners in the same manner.  It would be capable of being revoked by the individual at a later date.

At present under Irish law, an individual may nominate an attorney under an enduring power of attorney to act on their behalf in relation to property and personal care decisions should that individual become incapable in the future of managing their own affairs.  However, an enduring power of attorney does not currently deal with healthcare decisions.  The Bill proposes to extend the scope of the current law in relation to powers of attorney, allowing an individual to give an attorney power to give or refuse consent to the carrying out or continuation of a treatment by a person providing healthcare for the donor (the person granting the power of attorney) on their behalf.   However, the attorney would be subject to certain restrictions under the legislation, for example, it would not be possible to refuse administration of basic care or pain relief for the donor or for the attorney to continue to make decisions if the power of attorney had been revoked.

The rationale for a ‘living will’ is that it ensures due regard to a person’s right of dignity, bodily integrity, privacy and autonomy as their future healthcare treatment will not be decided by others. The passing of the Bill would bring Ireland into line with international obligations set out by the ‘’2006 UN Convention of Persons with Disabilities’’ and would provide welcome clarity for many medical practitioners and individuals alike on the making of healthcare decisions where a patient has lost capacity.

Contributed by Carol Hogan.