Families urged to discuss healthcare wishes after 4% said they have plan recorded

Safeguarding Ireland chairperson Patricia Rickard-Clarke said that 'making an advance healthcare directive is free of charge and not difficult to do'.

Families are being urged to talk about “do not resuscitate” and other medical decisions, as just 4% of people have their healthcare wishes recorded.

Safeguarding Ireland is urging more people to put in place a healthcare plan, known as an advance healthcare directive, as new research has found that 96% of people do not have one.

A Red C poll has found that just 23% understand what an advance healthcare directive is, and just 4% said that a healthcare professional had ever asked them if they have one.

The directive is a document in which a person writes down their future healthcare decisions — including refusals and consents on treatment, surgery, medicines, and resuscitation.

It only comes into effect if, in the future, a person then lacks capacity to make, or communicate, those decisions.

This could be due to the progression of a frailty, dementia, a serious illness, a physical or intellectual disability, or a sudden accident.

Safeguarding Ireland chairperson Patricia Rickard-Clarke said the uptake of advance healthcare directives is very low in Ireland, compared to other countries.

“Making one is free of charge and not difficult to do. It is an important part of protecting rights and ensuring that our wishes will be respected if, in the future, we didn’t have decision-making capacity for healthcare decisions," she said.

It is also better for doctors and families 

The poll found that 62% of people have “never really thought” about drawing up a plan that would outline their wishes around life-sustaining treatments, artificial nutrition, surgery, medicines, and resuscitation.

In drawing up a plan, people can express their views on medical and treatment options — including pain relief and where someone would like to be treated.

Advance healthcare directives also appoint designated healthcare representative, to ensure the plan is correctly interpreted and complied with.

Of those surveyed, 53% said they have no current health problems and believed they didn’t don’t need it, while 31% considered themselves too young to need one.

Ms Rickard-Clarke added that there can be confusion on the role of a next of kin, but the law is clear on this.

“People sometimes incorrectly think that an available family member, or next of kin, can step in and make healthcare decisions on another family member’s behalf. This is not the case.

“A next of kin can be a contact point, but has no authority regarding another person’s healthcare decisions unless appointed as their designated healthcare representative.”

She said that once a person has made an advance healthcare directive, it is important that those who need to know about it do. 

A copy should be given to the person’s designated healthcare representatives, family doctor, any current healthcare professionals a person is engaging with, the emergency department if admitted to hospital, as well as the person in charge if living in a healthcare or residential facility.