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

2CHAPTER 2ADVANCE CARE DIRECTIVES, HEALTH CAREPROXIES AND OTHER THIRD PARTIESAIntroduction2.01 In this chapter the Commission discusses how third parties may oftenbe involved in the decision-making process on which a person has expressedhis or her wishes in an advance care directive. This arises from the practicalreality that, when the time comes to make a specific medical decision, theperson who has made the advance care directive is not available to give theirviews directly. If the advance care directive is a simple ―do not resuscitate me insuch an event‖ this may not be a major issue, but quite often it may not be assimple or straightforward as this. Hence the need to nominate another person tomake these decisions, often called a health care proxy.2.02 The Commission discusses the role of a health care proxy in Part D,below. Before doing so, the Commission discusses the role of two other thirdparties. In Part B, the Commission discusses how a health care proxy appointedby a person with capacity in an advance care directive differs from thearrangements for the appointment of a personal guardian for a person withlimited or no capacity envisaged in the Government‘s Scheme of a MentalCapacity Bill 2008. The Commission also discusses the role of third parties whoassist a person with limited or no capacity in an informal way. In Part C, theCommission notes how the proposals in the Scheme of a Mental Capacity Bill2008 to extend the role of an attorney appointed under the Powers of AttorneyAct 1996 to include health care decisions would complement, though notsupplant the need for, the Commission‘s proposals in this <strong>Report</strong>.BPersonal Guardians and Third Party Informal Decision Making2.03 The Government‘s Scheme of a Mental Capacity Bill 2008 envisages(in line with the recommendations in the Commission‘s 2006 <strong>Report</strong> onVulnerable Adults and the Law) two different types of third parties of relevanceto this <strong>Report</strong>. The first type is a personal guardian appointed by Court to assista person with limited or no capacity and the second is a third party who assistsa person with limited or no capacity with informal decision making.43