Written answers

Tuesday, 10 November 2015

Department of Health

Advance Health Care Directives

Photo of Patrick O'DonovanPatrick O'Donovan (Limerick, Fine Gael)
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366. To ask the Minister for Health his legislative plans in respect of the issue of the do not resuscitate code, particularly in cases where a person is at end-of-life and there are no written instructions; and if he will make a statement on the matter. [39067/15]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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In July 2015, legislative provisions relating to advance healthcare directives were incorporated into the Assisted Decision-Making (Capacity) Bill 2013. An advance healthcare directive (AHD) is a statement made by an individual with capacity setting out his or her will and preferences regarding treatment decisions that may arise in the future when he or she no longer has capacity. The guiding principle underpinning the AHD provisions is that an adult with capacity is entitled to refuse treatment, including resuscitation, for any reason. The Assisted Decision-Making (Capacity) Bill was passed by the Dáil in October and has been referred to the Seanad for consideration. It is anticipated that the Bill will be enacted during the current Oireachtas term.

The HSE National Consent Policy was launched with immediate effect in May 2013. The policy deals specifically with the issues of Do Not Attempt Resuscitate (DNAR) orders (Part 4). This document discusses issues pertaining to cardio pulmonary resuscitation (CPR) and DNAR orders within the context of consent. The aim of the national policy is to provide a decision‐making framework that will facilitate the advance discussion of personal preferences regarding CPR and DNAR orders and to ensure that decisions relating to CPR and DNAR orders are made consistently, transparently and in line with best practice.

The policy states that decisions about CPR must always be made on a case-by-case basis and not, for example, on the basis of age, disability, the subjective views of healthcare professionals regarding the individual’s quality of life or whether he/she lives in the community or in long-term care. In addition, it states that such decisions should be made in the context of the individual’s overall goals and preferences for his/her treatment and care as well as the likelihood of success and potential risks.

An implementation guide to support Part Four of the HSE National Consent Policy is in the final stages of development and will be aligned with recent and forthcoming legislation and will be rolled out to the system when finalised.

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