Consultation Paper on Bioethics - Law Reform Commission

We urge them to use the Policy as a template for their own protocols
and procedures...We envisage a cohesive and integrated approach
to maximise consensus decision-making without imposing an
obligation on physicians to provide inappropriate medical care. Such
an approach, coupled with an extensive program of public education
and awareness of the end-of-life decision-making process, will serve
the citizens of Manitoba well.” 111
I Conclusion
2.47 Irish Common Law may recognise an advance care directive on the
basis of the views expressed by the Supreme Court in Re a Ward of Court (No
2), 112 but in the Commission‟s view, the lack of clear guidance to date illustrates
the need for legislation. Clarity is required on who can make healthcare
decisions for an incompetent patient, what form an advance care directive may
take and also whether a person‟s family can make a decision on his or her
behalf. In this respect, the Commission provisionally recommends that advance
care directives be placed on a statutory footing. The Commission also
provisionally recommends that, in view of the complexity associated with the
many issues that arise in this context, a set of guidelines be drawn up to
complement the legislative framework.
2.48 The Commission provisionally recommends that advance care
directives be placed on a statutory footing. The Commission provisionally
recommends that a set of guidelines be drawn up to complement the legislative
framework.
J Advance care directives refusing treatment on religious grounds
(1) Ireland
2.49 Denham J expressly enshrined the right of a competent adult to
refuse any medical treatment in Re a Ward of Court (No 2):
“The right to life is the pre-eminent personal right. The State has
guaranteed in its laws to respect this right. The respect is absolute.
This right refers to all lives – all lives are respected for the benefit of
the individual and for the common good. The State‟s respect for the
life of the individual encompasses the right of the individual to, for
111 Manitoba Law Reform Commission Report on Withholding or Withdrawing Life-
Sustaining Medical Treatment (No 109 2003) at 108.
112 [1996] IR 79
58