Terence Flanagan (Dublin North East, Fine Gael)

I, too, welcome the introduction of the Advance Healthcare Decisions Bill 2012 by Deputy Liam Twomey. The Bill will allow individuals to decide in advance the extent of the medical treatment to be given when they are no longer able to make that decision, due to incapacity or illness.

There is no Irish legislation in this area but living wills are popular in the United States. A survey in 2007 found that 40% of the population of the United States have made a living will. In Europe, the adoption of living wills has varied from country to country. In Germany and Spain legislation has given binding force to advance healthcare directives while in England and Wales the legislation is linked to mental capacity regulations.

As someone who is pro-life and has ultimate respect for human life, I have concerns about the Bill and, in particular, about the complexity of some of the issues involved. For example, a person may change his or her mind about a living will and forget to update it. Such a person may not be in a position to communicate that change of mind, should he or she be incapacitated at the end of his or her life. We know that people who attempt suicide often regret doing so. How will such changes of mind be factored into the Bill?

I share some of the concerns expressed in the public domain that the introduction of living wills is a high-risk strategy that might lead, over time, to the introduction of assisted suicide or euthanasia. I welcome the remarks of the Minister and of Deputy Twomey that both are illegal at present. There is, nevertheless, a perception that the introduction of living wills may lead us down that road. Other Deputies have referred to this danger. I merely flag this issue.

In the United Kingdom in 2009, Ms Kerry Woolterton died tragically at the age of 26, having swallowed anti-freeze. Ms Woolterton was fully conscious when she was brought to hospital. She was clutching a living will and stated that she did not want to be saved and that she was 100% aware of the consequences of her wishes. The consultant sought legal advice and did not intervene. Some public concern was expressed that living wills should apply only when a patient does not have the mental capacity to make a decision. The case of Ms Woolterton was tragic. Her father blamed the doctors for not saving her life. We must be aware of situations such as this as we introduce this type of legislation. It would be a concern for accident and emergency units if people with living wills were hospitalised following the introduction of the legislation. I welcome the introduction of the Bill. However, we must tread with caution and take into account the experiences of other countries, in particular in the United Kingdom.

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