Irish Law Reform Commisssion To Consider Advance Medical Directive

There is a need for legislation to cater for people who want to make advance care directives – in other words, who want to make their wishes known about what should happen to them in the event of an incapacitating accident or illness, the Law Reform Commission (LRC) has said.

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 a stroke or Alzheimer’s disease, that makes it impossible for them to communicate their wishes directly.

Such a 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.

At its annual conference today, the LRC is launching its Consultation Paper on Bioethics: Advance Care Directives, which forms part of its Third Programme of Law Reform 2008-2014.

The paper provisionally recommends that there is a need for legislation in this area and it makes 25 specific recommendations on the topic. Some of the main recommendations it makes are:

-The proposed legislation would not involve euthanasia or assisted suicide and it would not allow a person to refuse basic care.
-It would only deal with advance care directives involving refusal of treatment, e.g. ‘I do not wish to be resuscitated’. It would not deal with requests for treatment, e.g. ‘I want a liver transplant’.
-An advance care directive could be written or verbal, however 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.
-A person should be encouraged to seek medical advice when making an advance care directive, but this should only be mandatory in the case of directives involving the refusal of life sustaining treatment.
-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.

The Law Reform Commission is an independent statutory body whose main role is to keep the law under review and to make proposals for reform. Today’s conference is taking place at Dublin Castle.

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