The HSE Quality Improvement Division are looking for your views on Advance Directives codes of practice 'Living Wills'. Advance directives are something you can do in advance in the event that you not have capacity to give instructions on your health care in the future.

Advance Healthcare Directives Codes of Practice

National Consultation - Closing Date Friday 4th May 2018

Advance Healthcare Directives have been introduced into Irish law as part of the Assisted Decision-Making (Capacity) Act 2015.

What is an Advance Healthcare Directive?

An Advance Healthcare Directive is simply a document which sets out your instructions of the kind of healthcare treatments you want or wish to refuse in the future when you no longer have capacity to do so. There is no legally required format for an Advance Healthcare Directive and you do not need a lawyer, solicitor or advice from a health and social care professional to make one. However, some legal formalities must be complied with. You should also ensure that your Advance Healthcare Directive is suitable for your needs.

Any person aged 18 and over who has decision-making capacity can make an Advance Healthcare Directive. The Advance Healthcare Directive will come into effect when they lack decision-making capacity to make healthcare treatment decisions for themselves. The Advance Healthcare Directive will provide Health and Social Care Professionals with important information about a person’s healthcare treatment choices. It will also enable a person to be treated according to his or her own ‘will and preferences’ even when he or she no longer has decision-making capacity to make decisions. A person’s ‘will and preferences’ are their wishes, views, beliefs and values.

There is no obligation to make an Advance Healthcare Directive. The person making the Advance Healthcare Directive can refuse healthcare treatment in advance. Their Advance Healthcare Directive must clearly identify the type of healthcare treatment that they wish to refuse and the circumstances under which healthcare treatment will be refused.

What is a Designated Healthcare Representative?

A person can appoint a ‘Designated Healthcare Representative’ who is a trusted person chosen by them to ensure that the terms of the Advance Healthcare Directive are complied with when s/he no longer can make these decisions for him or herself. The Designated Healthcare Representative can provide direction to Health and Social Care Professionals in relation to healthcare treatment decisions as specified in the person’s Advance Healthcare Directive. They can also consent and refuse treatment on behalf of the person if this has been specified in their Advance Healthcare Directive.

A person cannot include requests in their Advance Healthcare Directive which are criminal acts in Irish law including euthanasia or assisted suicide.

An Advance Healthcare Directives Multidisciplinary Working Group has been established under the Act by the Minister for Health, Simon Harris, T.D. to prepare draft codes of practice in relation to the Advance Healthcare Directive provisions contained in the Act.

Draft Codes of Practice on Advance Healthcare Directives

Three Draft Codes of Practice have been developed as follows:

1. A Draft Code of Practice for Health and Social Care Professionals on Advance Healthcare Directives

This code is for all health and social care professionals who are interacting with persons in relation to Advance Healthcare Directives. This Code seeks to give guidance to health and social care professionals in relation to meeting their statutory obligations under Part 8 of the Assisted Decision Making (Capacity) Act 2015. It explains what an Advance Healthcare Directive is; sets out the formalities in making, revoking and amending an Advance Healthcare Directive; and provides direction for Health and Social Care Professionals when interacting with persons who have made an Advance Healthcare Directive and their designated healthcare representatives.

Click here to view the Draft Code of Practice for Health and Social Care Professionals

2. A Draft Code of Practice on How to Make an Advance Healthcare Directive

This Code is for anyone who is considering making, or who has made an Advance Healthcare Directive and for anyone who is supporting a person to do so. It explains what an Advance Healthcare Directive is; sets out the steps to be taken in making an Advance Healthcare Directive; and identifies important matters to be considered in making an Advance Healthcare Directive.

Click here to view the Draft Code of Practice on How to Make an Advance Healthcare Directive

3. A Draft Code of Practice for Designated Healthcare Representatives

This Code provides guidance for Designated Healthcare Representatives in relation to Advance Healthcare Directives. It details what s/he needs to know in carrying out his or her role, explains the functions, duties and restrictions that apply to the role. The Code also explains how a Designated Healthcare Representative is appointed. It provides details on how the role of the Designated Healthcare Representatives is overseen by the Director of the Decision Support Service.

Click here to view the Draft Code of Practice for Designated Healthcare Representatives

Consultation

We would like to hear your views and feedback on the three Draft Codes of Practice. We welcome feedback from individuals, groups and organisations. As the Draft Codes of Practice are interlinked it would be very beneficial if you could give feedback on all three draft codes.

We would appreciate if you could disseminate this information to your colleagues and through your internal communication processes including websites, email, newsletters and through your social media sources so that it reaches as many people as possible.

A short questionnaire has been developed to help you provide feedback. Click here to access the consultation.

Please don't hesitate to contact us on adm@hse.ie if you require a Word or PDF version of the questionnaire.

The closing date for feedback is the Friday May 4th 2018.

Following the consultation process, the draft codes of practice will be amended, signed off by the Advance Healthcare Directives Multi-Disciplinary Group and submitted to the Director of the Decision Support Service, Ms. Áine Flynn, for consideration.

As per Section 91 (4) of the Assisted Decision Making (Capacity) Act 2015 the Director shall:

• Make the Draft Codes available to the appropriate persons;


• Invite written representations, allowing at least 30 days;


• Consider jointly with the working group, any representations received;


• After consultation with the working group, make any appropriate modifications.

The Director shall not publish the code(s) of practice except with the consent of the Minister for Health in accordance with Section 91 (5) of the Assisted Decision Making (Capacity) Act 2015.

Further details and progress updates will be available at www.assisteddecisionmaking.ie.

Please contact Marie Tighe or Jacqueline Grogan at adm@hse.ie if you have any queries or need more information.

Find out more about the Assisted Decision-Making (Capacity) Act 2015.