What is the ADMA?
The Assisted Decision-Making (Capacity) Act 2015, or ADMA, established a new legal framework for supporting people to make their own decisions through all phases of their life. Among other important changes to providing individuals with more autonomy throughout their lives, the ADMA also grants Advance Healthcare Directives full legal standing. The Act was fully commenced on 26th April 2023. Find more information on this law on the Decision Support Service web site.
What is capacity?
Capacity is a person’s ability to decide for themselves. It centres on the person’s ability to make a specific decision at a specific time. For someone to have capacity, they must be able to carry out the following:
- Understand information relevant to the decision
- Keep that information long enough to make a voluntary choice
- Use or weigh up that information as part of deciding
- Communicate their decision in whatever way they communicate (not only verbally)
How do I know if an Advance Healthcare Directive is valid?
To be valid, an Advance Healthcare Directive must be signed and witnessed. The person who made the Directive, their Designated/Alternate Healthcare Representatives (if appointed), and two witnesses must sign and date the document at the same time. Only one witness may be a member of the Directive-Maker’s family, the other must be no relation. This is to help safeguard a person from coercion and other forms of abuse.
Additionally, an Advance Healthcare Directive is only valid if it is created when the Directive-Maker has capacity.
If these requirements are met, the Advance Healthcare Directive is valid. If there are questions about the validity of an Advance Healthcare Directive, you may file a complaint with the Decision Support Service.
Is there a Register of Advance Healthcare Directives?
At present, there is no register for Advance Healthcare Directives. We anticipate that there will be a register in the future.
At the moment, it is the responsibility of the individual to make copies of their Directive and share it with family, friends, and their healthcare team. Individuals should make sure that a copy is placed in their healthcare file. Additionally, a person should complete and share the Medical Summary Form. IHF encourages people to keep their Medical Summary Form in an obvious and easy accessible place.
What is the difference between an Advance Healthcare Directive and an Enduring Power of Attorney?
An Advance Healthcare Directive allows you to record what kind of healthcare treatments you would refuse or request, and allows you to appoint someone to speak on your behalf for your healthcare decisions should you lack capacity in the future.
An Enduring Power of Attorney appoints someone (called your attorney) to make decisions for you about your day-to-day personal care and/or your financial decisions.
Is refusing treatment the same as assisted dying?
No. Refusing medical treatment is always an option available to anyone who has capacity to make and express decisions, or who made and recorded those decisions in an Advance Healthcare Directive. For example, a person may refuse certain medications that cause difficult side effects, but this is not the same as taking steps to end their life.
However, assisted dying is the purposeful taking of medication to bring about immediate death. It is not currently legal in Ireland.