Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

It is well established in Irish case law that a person with capacity has the right to refuse all forms of treatment. The ward of court case found artificial nutrition and hydration are considered to be medical treatment as opposed to basic care, and, therefore, a person is entitled to refuse such treatment.

The provisions of the Bill allow a person to make treatment requests in their advanced health care directive, which would, of course, include a request for artificial nutrition and hydration if they so wish. However, a person's autonomy is not absolute and he or she cannot demand that specific treatments or interventions be provided in all circumstances regardless of their effectiveness. The right to request treatment is a power to consent rather than a power to compel.

As outlined in HSE’s national consent policy, a health care professional is not obliged to provide a treatment that is not clinically indicated. This is also in keeping with the Medical Council’s 2009 guidelines, which state that a clinician is not obliged to provide a treatment that he or she considers to be futile or disproportionately burdensome, even where such treatment may prolong the patient’s life. However, a treatment request in an advance health care directive is reflective of that person's will and preferences. Therefore, the provisions state that treatment requests outlined in an advance health care directive will be taken into consideration during the decision-making process, but will not be legally-binding. In situations where a request for treatment in a person's advance health care directive is not upheld, the reasons for not complying must be recorded in that person's health care record. This reasoning must also be explained to that person's designated health care representative if he or she has nominated one.

Given that a request for any form of treatment cannot be legally binding, I cannot accept Senator Mullen's proposed amendment.