It has been reported by the BBC that a new “right to die” (advance decision) card is being offered in pubs, banks, libraries, GP surgeries and churches by Salford City Council. It is designed to fit in a purse or wallet.
The council has stated that it wanted to put information out in public places so that people could make their own choice.
It is worth noting some relevant requirements of the Mental Capacity Act 2005 in the event that practitioners are presented/find one of these cards when treating an incapacitated patient:
- It is important to establish at the time whether a patient has capacity before relying on an advance decision. If the patient has capacity then they must be consulted about their treatment.
- A person must be 18 years old or over and have capacity to create a valid advance decision. A valid advance decision (which has not been revoked) will have the same effect as if the person who made it still had capacity when the advance decision is relied upon.
- The appointment of a welfare attorney under a lasting power of attorney will override an advance decision.
- An advance decision must be valid and applicable to the treatment. It is not valid if it has been withdrawn at a time when the person had capacity to do so or has done anything else clearly inconsistent with the advance decision remaining his/her fixed decision.
- It must contain a clear statement of the treatment to be refused and the circumstances in which the decision will apply.
- If the advance decision relates to life-sustaining treatment it MUST:
- be verified by a statement from the patient to the effect that it is to apply to that treatment even if their life is at risk;
- be in writing;
- be signed by the patient (or by another person in the patient’s presence and by their direction); and
- it must be witnessed in writing.
It is important for treating teams to ensure that a copy of an advance decision relating to lifesustaining treatment (or a note that one exists) is placed in the patient’s records.
Chapter 9 of The Mental Capacity Act Code of Practice, which considers advance decisions in more detail, can be accessed here.