Public input sought on advance directive bill

The public is being asked to weigh in on proposed legislation on advance directives related to end-of-life care.

Health Ministry Chief Officer Jennifer Ahearn said the Health Care Decisions Bill is the result of a year of work by the ministry and health organizations in the Cayman Islands. Until now, there has been no legal provision for such arrangements.

In an email, Ms. Ahearn said the impetus for the bill came out of a healthcare conference in 2015 that included presentations on end-of-life decisions and palliative care.

An advance directive lets a person determine what course they would like physicians to take in a situation where the person has become mentally incapacitated or otherwise unable to communicate their wishes. It can cover such things as an order not to put the person on long-term life support or not to resuscitate them in specific situations.

The bill specifies that a person must be over 18 and mentally competent to file an advanced directive. The directive must be signed in front of two adult witnesses, neither of whom can be that person’s beneficiaries.

A person can revoke their own advance directive at any time, while mentally competent. This must be done in writing, signed and dated.

It is also possible for someone to appoint one or more proxies to act as a substitute decision-maker in cases where the directive maker becomes mentally incompetent. The underlying principle of such appointments is that these individuals should act consistently with what the directive maker would have decided.

Ms. Ahearn said such directives can alleviate potentially difficult decision-making in a time of crisis.

“I believe that this will make very difficult situations easier for families and loved ones as they will know what the patient’s wishes are and be able to honour them should the patient become unable to communicate their wishes themselves,” she said.

The public is being asked for input on the bill. Ms. Ahearn said the hope is to get a range of thoughts on the bill from the public.

“Do they support it?” she said. “Do they have any concerns with it? Are the forms in the schedule easily understood and would they be able to fill them out? Have we missed anything?”

Based on the feedback, she said, the bill will be modified and submitted to the Legislative Authority.

A link to the bill can be found at http://ministryofhealth.gov.ky.

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