Oireachtas Joint and Select Committees
Tuesday, 18 April 2023
Joint Committee On Health
Life Cycle Approach to Mental Health: Discussion
Mr. Mervyn Taylor:
On our website, sageadvocacy.ie, you will see a short video on the legislation called Minding Your Marbles. The legislation is among the most complex around. The consolidated Acts of 2015 and 2022 are an inch thick, but we took them down to a simple phrase. It is a colloquial phrase around Ireland. Many older people, when they forget something or are worried about their memory, say, "I must be losing my marbles." We took that phrase and decided to build the awareness around this issue because "minding your marbles" is the phrase people use. We have to realise that the legislation we are still under until Wednesday of next week dates from the year after the death of Charles Dickens. I refer to the Lunacy Regulation (Ireland) Act, 1871, and the system of wards of court relating to it. We know that all the ward of court cases will be reviewed.
There will also be people coming forward who will lack capacity. The courts - the Circuit Court rather than the High Court - will be looking at those cases and, where appropriate, appointing decision-making representatives. There are greater safeguards under that but it also needs the protection of liberty legislation and the safeguarding legislation. It is a profoundly important piece.
There is a development in relation to advance healthcare directives. They already have informal legal support. They are now formally recognised. That is one way older people can protect themselves, by appointing a designated healthcare representative. The second way is enduring power of attorney. There are very low levels of uptake of enduring power of attorney. I am one of them; I am considering it at present. However, it is not something that one would rush into. There are issues of cost. We are pleased to see the Legal Aid Board seems to be taking that on board in its planning for the future. Advance healthcare directives, the enduring power of attorney and a very good resource which was developed by the Irish Hospice Foundation or the Hospice Friendly Hospitals, Think Ahead, are the kind of resources we need to propagate so that people can get used to the idea that if they are in difficulty in controlling the decision-making process or if they lose the ability, either temporarily or permanently, they are still speaking and their wishes or, as it is known, will and preference can be taken into account.
Much more will have to be done. The legislation is a brilliant start. It is 20 years since the Law Reform Commission first started talking about the need for the legislation. I remember sitting in the Dáil Visitors Gallery in December 2015, which is a while ago, when the first main Act was passed. It is coming into effect next week. It is now about getting the support behind those mechanisms and encouraging people. For example, when people get their social welfare payments, there might be even little messages with which one might encourage them.
Advance healthcare directives, enduring powers of attorney, EPAs, etc., are making it much easier for people to mind their marbles. Coming back to that simple phrase, it is really important people engage with the fact they might even have a stroke in their 40s or some other illness in their 50s and that they need to have their will and preference known and somebody else to be to speak for them, which we do often for people. It would be an awful lot easier if we had those instruments widely and cheaply available.
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