New laws could allow patients to reject life-saving care

The Law Reform Commission (LRC) has recommended new legislation which will give patients the power to refuse life-saving treatment.

The advance care directives, or "living wills", as specified in the report, Bioethics: Advance Care Directives, will allow patients to make treatment decisions in advance, in case they suffer an illness or accident that leaves them unable to communicate their wishes directly.

The report has been branded by some as a welcome move to clarify a controversial topic in medical law. The LRC recommends that:

• the advance care directives would not alter current legislation on euthanasia and assisted suicide
• directives could include an instruction to refuse life-sustaining treatment, but only if it is provided in writing with a witness present
• the new legislation would allow patients to refuse medical treatment on religious grounds 
• patients would not be able to refuse basic care such as nutrition, hydration and hygiene under the new legislation
• patients would be advised to seek medical advice when making an advance care directive – but this would not be compulsory
• the new legislation would not mean medical professionals would be legally liable if a directive they believe to be valid, later comes under investigation
• professional bodies would be able to investigate medical practitioners if they failed to honour an advance care directive.

The LRC also believes a statutory code of practice on advanced care directives should be created to provide guidance for healthcare professionals.