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

1.45 In the Supreme Court, Hamilton CJ specifically quoted from andapproved the views expressed by Costello J in his 1986 lecture on theterminally ill. 54 He added: 55―A competent adult if terminally ill has the right to forego ordiscontinue life-saving treatment... and that the exercise of that rightwould be lawful and in pursuance of [the person‘s] constitutionalrights.‖1.46 Similarly, O‘Flaherty J stated:―consent to medical treatment is required in the case of a competentperson... and, as a corollary, there is an absolute right in a competentperson to refuse medical treatment even if it leads to death.‖ 56He considered that ―it would be correct to describe the right in our law asfounded both on the common law as well as the constitutional rights to bodilyintegrity and privacy.‖ 57 Denham J agreed, adding that:―…medical treatment may be refused for other than medical reasons,or reasons most citizens would regard as rational, but the person offull age and capacity may make the decision for their own reasons.‖ 581.47 Although the Ward of Court case did not require the courts to dealdirectly with advance care directives, as in Bland the Supreme Court madeindirect references to the issue. O‘Flaherty J stated that he found it:―impossible to adapt the idea of the ‗substituted judgment‘ to thecircumstances of this case and, it may be, that it is only appropriatewhere the person has had the foresight to provide for future5455565758[1996] 2 IR 79, at 125.Ibid, at 125-6.Ibid at, 129.Ibid.Ibid at 156. It is interesting to note that the following italicised line in theunreported approved judgment of Denham J in Re a Ward of Court (No 2) 27 July1994 at 24 does not appear in either In re a Ward of Court (withholding medicaltreatment) (No 2) [1996] 2 IR 79 at 156 or In re a Ward of Court (withholdingmedical treatment) (No 2) [1995] 2 ILRM 401 at 454:―…medical treatment may be refused for other than medical reasons. Suchreasons may not be viewed as good medical reasons, or reasons most citizenswould regard as rational, but the person of full age and capacity may take thedecision for their own reasons.‖23