PEOPLE will be able to refuse life-prolonging medical treatment through legally backed “living wills” under plans outlined by ministers yesterday.
For the first time people who fear that they will suffer from Alzheimer’s disease or other dementia will be able to appoint a relative or friend to take decisions on health and welfare, as well as money, as now. But the reforms will not change the law on euthanasia.
The changes, outlined yesterday in a Mental Capacity Bill, will allow the appointment of a nominee who will be able to instruct doctors not to give life-sustaining treatment, where the patient has expressed that wish.
Living wills are already possible, but there is confusion as to when and how far they should be followed. For the first time, the Bill gives them recognition in statute and sets out the circumstances governing their use.
The measures, expected to come into force in 2007, have been drawn up after extensive consultation. It sets out a new legal framework for the mentally incapacitated, setting down principles to safeguard them from abuse; makes clear their rights and also the law governing the decisions made by carers on patients’ behalf.
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There is a new legal obligation on carers and professionals to take account of views of family and friends.
The Bill has prompted concern in some quarters that it opens the door to euthanasia. Lord Filkin, the Constitutional Affairs Minister, said yesterday: “This Bill expressly provides that it does not affect the law on murder, manslaughter or assisted suicide.”
“I hope the Bill we have published today will finally lay to rest the misplaced concerns about euthanasia.”
There are currently two million people affected by lack of mental capacity in the UK, including 700,000 from dementia. But this is expected to rise to some 840,000 by 2021 and to continue to do so as the population ages.
“It is likely that many of us could suffer mental incapacity in future and it’s likely that more of us will suffer these problems as we live longer. It’s really important that there is a clear legal framework setting out the ethical protocol on how people who lose their mental capacity should be treated,” Lord Filkin added.
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The Bill sets out several overriding principles, including that a person is assumed capable and to have the right to make decisions unless proved otherwise. People are also to have the right to make what might be seen as “eccentric or unwise” decisions; and given all help to make their own decisions before it is concluded that they cannot do so.
A decision made on their behalf must be the “least restrictive of their basic rights and freedoms”, the Bill says.
A second key principle is that if there is any doubt about capacity or a course of medical treatment, the presumption is in favour of preserving life.
Among specific changes are: