Dr. Simon Mills:

Professor Huxtable could also answer. An advance statement is a statement made at a time when one has the mental capacity to make a treatment decision. It is made at that time with the intention of being relied upon at a future date when the person no longer has capacity to make that treatment decision.

To some extent, it happens every day in every Irish hospital. When a person signs a consent form for surgery, it states that he or she consents to undergo the operation and any procedures that may be necessary during the course of the operation. The person in that situation has given an advanced directive. The medical staff cannot wake up that person on the operating table and ask if he or she wants to have the additional procedure. What I mean is that the medical staff could do so, but, in general, I think they probably should not.

The issue of advance statements is a particularly complicated area of law in which there is substantial philosophical disagreement, including on the question of whether someone is the same person when he or she makes the advance statement as he or she is when the statement comes to be relied on. Dr. Mulligan referred to this wonderful discussion between the philosophers Dresser and Dworkin, I think it was, about the issue of how a person changes as he or she loses capacity. This is worth revisiting at some length further down the line. My view is that people should have the capacity at the time of exercising a decision to end their lives and that it should not be left to advance statements. That is my personal view. I can see there is a basis for contrary arguments and I would be very interested to hear a debate about this issue because I maintain an open mind, but this is my personal starting point.