Report on Bioethics: Advance Care Directives - Law Reform ...

5.07 The Commission recommends that informed decision making shouldbe a principle that forms part of the legislative framework on advance caredirectives. The Commission also recommends that it should be made clear thata person is entitled to refuse medical treatment for reasons that appear not tobe rational or based on sound medical principles and to refuse medicaltreatment for religious reasons. [paragraph 1.92]5.08 The Commission recommends that the principles of autonomy,dignity and privacy of the individual should form part of the legislative frameworkfor advance care directives. [paragraph 1.100]5.09 The Commission recommends that if, following an appropriateprocess of consultation, a reasonable doubt exists as to the validity or meaningof an advance care directive, any such doubt must be resolved in favour ofpreserving life. [paragraph 1.106]5.10 The Commission recommends that the existence of any advancecare directive, including an advance care directive involving the appointment ofa health care proxy, be brought to the attention of the Court when (as envisagedin the Scheme of a Mental Capacity Bill 2008) it considers the appointment of apersonal guardian. The Commission also recommends that the powers of apersonal guardian should not include any powers which would conflict with anyprovision in an advance care directive. [paragraph 2.07]5.11 The Commission recommends that the Government‘s Scheme of aMental Capacity Bill 2008 be extended to provide that a person may appoint anattorney under an enduring power of attorney (EPA) to make decisionsregarding life-sustaining treatment, organ donation and non-therapeuticsterilisation, provided that these are expressly provided for in the EPA.[paragraph 2.22]5.12 The Commission recommends that, in general, in the event of aconflict between the terms of an enduring power of attorney (EPA) executedunder the Powers of Attorney Act 1996 and an advance care directive, the EPAshould take priority over an advance care directive. The Commission alsorecommends that, where it appears that a conflict arises between the terms ofan EPA and an advance care directive, there should initially be an attempt toresolve any apparent conflict informally, involving the donee of the enduringpower of attorney and the relevant health care professional, and, whereapplicable, the health care proxy. The Commission also recommends that, inthe absence of agreement between the parties, the matter should be referred tothe High Court for resolution. [paragraph 2.24]5.13 The Commission recommends that a health care proxy may beappointed under an advance care directive [paragraph 2.31]102