Implications for Healthcare & End-of-Life Decisions

Relevance to healthcare and end-of-life decisions

  • The Assisted Decision-Making (Capacity) Act 2015 applies to all health and social care settings and will have a significant impact on the delivery of good quality end-of-life care.
  • The Act provides for the individual’s right to autonomy and self-determination to be respected when they may have an issue with decision-making capacity through provisions relating to an Enduring Power of Attorney and Advance Healthcare Directives. Both of these documents can be made by a person when they have capacity and state what they would like/not like to happen in relation to different aspects of their healthcare, should the need arise.
  • The legislation supports advance care planning, a process of discussion and reflection about goals, values, and preferences for future and end-of-life care. This process usually takes place with a doctor or nurse.
  • The legislation includes a provision for creating an Advance Healthcare Directive, a document where a person can write down what they would not like to happen in relation to certain medical care treatments. An advance healthcare directive only comes into force when that person loses decision-making capacity, becomes ill, and the circumstances in their advance healthcare directive arise. Within an advance healthcare directive, a person can refuse treatment up to and including life-sustaining treatments but cannot refuse “basic care”. See IHF Briefing Paper on advance healthcare directives, the Think Ahead programme and this guidance document for more information. When commenced, the legislation will enable healthcare professionals to be provided with important information about a person and their preferences in relation to treatment up to and including the end of life in order to ensure that the care they provide is in keeping with the person’s expressed wishes. It will offer clarity on the roles and responsibilities of healthcare professionals with regard to advance care planning and advance healthcare directives.
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