Dr. Frank Conaty:

In the context of how the guidelines refer to the decision environment, as I would term it, the factors that have to be taken into consideration in making decisions on access to critical care can be very wide. I emphasise that the commission is not indicating what the answer should be, but that consultation is required.

For example, the guidelines speak to aspects such as life years, quality of life and the application of frailty scores. The manner in which those may be brought into the frame in terms of decision-making meeds to be teased out properly and discussed. We need consultation across those who may be directly impacted. There is no particular guidance or clarity in the guidelines at the moment as to what we actually mean by life years. Are we suggesting that one person's life year is equivalent to another person's life year? None of these discussions are evident from the document. Crucially, we do not see evidence - it may have happened and we would like to see it - of discussing the guidelines in the context of human rights law, international and domestic. We should bring those principles to the fore in the discussion on where these guidelines should go.