Finian McGrath (Dublin North Central, Independent)
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Question 339: To ask the Minister for Health and Children if she will make a statement as to the availability of records relating to the withdrawal of artificial hydration and nutrition in Irish hospitals in the end of life context or the nature of Department guidelines on this important issue. [4698/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Medical Council is the statutory body charged with responsibility for, inter alia, the governance of the practice of medical practitioners. Policy guidelines in respect of the issue raised by the Deputy are set out in the Medical Council "Guide to Ethical Conduct and Behaviour of Medical Practitioners".

The relevant extract from the Ethical Guide states as follows:

For the seriously ill patient who is unable to communicate or understand, it is desirable that the doctor discusses management with the next of kin or the legal guardians prior to the doctor reaching a decision particularly about the use or non-use of treatments which will not contribute to recovery from the primary illness. In the event of a dispute between the doctor and relatives, a second opinion should be sought from a suitably qualified and independent medical practitioner.

Access to nutrition and hydration remain one of the basic needs of human beings, and all reasonable and practical efforts should be made to maintain both.

Where death is imminent, it is the responsibility of the doctor to take care that the sick person dies with dignity, in comfort, and with as little suffering as possible. In these circumstances a doctor is not obliged to initiate or maintain a treatment which is futile or disproportionately burdensome. Deliberately causing the death of a patient is professional misconduct.

Hospital records in relation to this issue are a matter for the Health Service Executive. My Department has therefore asked the Parliamentary Affairs Division of the Executive to arrange for a response to be issued to you directly in this regard.

Finian McGrath (Dublin North Central, Independent)
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Question 340: To ask the Minister for Health and Children if her attention has been drawn to the fact that a recent report from the Care for the People Dying in Hospitals Project in Our Lady of Lourdes Hospital, Drogheda, found that fear of litigation was seen as a significant factor which shaped the care of the dying ethos and that the dying state as a legitimate diagnosis was still not fully recognised; if her Department has a policy on ensuring appropriate care for the dying; her views on whether the appointment of full-time clinical ethicists in hospitals, as is now commonplace in the United States, would make an important contribution to the overall decision making process in the end of life context. [4699/07]

Seán Power (Kildare South, Fianna Fail)
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I have noted the contents of the Report referred to by the Deputy. I consider that the document makes a useful contribution to our understanding of the needs of those at the last stage of their life. I am committed to promoting the dignity of persons who are dying, whether in hospital or other settings. I have no plans regarding the appointment of clinical ethicists but I will ask the Health Service Executive to keep international developments in this area under review.

Finian McGrath (Dublin North Central, Independent)
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Question 341: To ask the Minister for Health and Children if, in view of the fact that the web pages of her Department provide detailed information explaining the nature of advance care directives, she will make a statement as to the Government's understanding of the present legality of such instruments and the advisability of introducing legislation to clarify the law in this area. [4701/07]

Seán Power (Kildare South, Fianna Fail)
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The web pages referred to by the Deputy are contained in the Consumer Section of the Department of Health & Children's website (under Health Information). The information in this section is provided in conjunction with the citizens information website, (formerly known as OASIS) provided by Comhairle. Health related topics are copied to the Department of Health and Children's site by way of a regular feed. Further enquiries on the individual topics covered should initially be referred to the citizens information website. The information provided on Advance Care Directives was commissioned by Comhairle and then placed on their website.

Advance Care Directives are an emerging issue, and the Department will continue to monitor international developments in this area. There are no plans to introduce legislation on this issue at present.