Advance Healthcare Directive FAQ - Ireland


An Advance Healthcare Directive is a written document that is used to express your healthcare wishes when you are no longer able to personally communicate those wishes.
Healthcare Directive Basics
I'm getting older. What documents should I have in place?

If you are getting older or if you have dependants, there are three documents you should prepare to help your loved ones manage your affairs.

  1. Advance Healthcare Directive: Your Advance Healthcare Directive (also called a Living Will) is used to appoint someone to make healthcare decisions for you and describes any medical treatment preferences you may have in the event you are no longer able to communicate or are incapable of giving consent.
  2. Power of Attorney: Your Power of Attorney grants authority over your personal and financial decision making to someone you trust in case you become unable to communicate or incapable of giving consent. A Power of Attorney may also be used to grant full or limited powers over your financial affairs when you will be travelling or otherwise unavailable.
  3. Last Will: Your Last Will describes how to distribute your estate after you die.
What is an Advance Healthcare Directive?

An Advance Healthcare Directive, also called a living will, sets out in writing your wishes for your medical care and treatment. It may also name a person to make sure those wishes are carried out. Usually, an Advance Healthcare Directive contains specific directions on the use of life-sustaining treatments and cardiopulmonary resuscitation (CPR). It may also specify treatments you do not want to receive in certain circumstances.

What is the difference between a Last Will and an Advance Healthcare Directive?

A Last Will is used to distribute your property after your death. An Advance Healthcare Directive allows you to specify, in writing, your healthcare preferences for the time when you no longer have capacity to provide consent. A Last Will cannot be used to specify what type of medical treatment you want.

Why do I require an Advance Healthcare Directive?

Should you suffer from an accident or illness, you may not be able to communicate the type of treatment you wish to receive. In such circumstances, your healthcare provider and your family will be obliged to guess what your healthcare wishes are. However, if you have signed an Advance Healthcare Directive, your healthcare wishes will be clear and no guess work will be required.

Do I need a lawyer to create an Advance Healthcare Directive?

No. An Advance Healthcare Directive can be created without the assistance of a lawyer.

Do I need an Advance Healthcare Directive if I already have a last will and testament?

Yes. Advance Healthcare Directives and last wills are very different. Your last will and testament deals with the distribution of property after your death. In contrast, an Advance Healthcare Directive deals with your healthcare and applies when you are alive and cannot communicate your wishes.

Will my healthcare provider be obliged to follow the instructions in my Advance Healthcare Directive?

An Advance Healthcare Directive that is valid and applicable to specific treatment is legally binding and doctors are legally bound to follow its instructions. However, a person cannot demand treatment that is unnecessary.

How long will an Advance Healthcare Directive last?

An Advance Healthcare Directive will last until the time of your death unless you have revoked it sooner.

The Directive-Maker
Who is the directive-maker?

The directive-maker is the person who will be requiring someone else to act for him or her. The directive-maker must be an adult. The directive-maker must be of "sound mind" and capable of making his or her own decisions at the time the Advance Healthcare Directive is executed (signed).

Can anyone be a directive-maker?

Anybody who is mentally capable and who is 18 years of age or older may make an Advance Healthcare Directive for themselves.

The Designated Healthcare Representative
Who is the designated healthcare representative?

The person appointed by the directive-maker is called the designated healthcare representative. The designated healthcare representative is the person who acts for the directive-maker in the event the directive-maker is no longer able to communicate his or her wishes.

Who cannot act as my designated healthcare representative?

Your designated healthcare representative should not be:

  • someone who is mentally incapable;
  • someone who is under 18 years of age;
  • someone who is caring for you in return for payment;
  • an owner/operator of the residential or healthcare facility where you are living; or
  • an employee of an operator of the residential or healthcare where you are living.
Who should I choose to act as my designated healthcare representative?

Ensure that you choose an individual whom you trust and whom you feel comfortable sharing your wishes. It is not necessary to choose a healthcare representative who shares all your beliefs, however you should choose an individual whom you are confident will respect your wishes and who will do his/her best to get the type of healthcare treatment you want.

It is important to choose a healthcare representative who will be available when required to make your healthcare decisions. There may come a time where you require someone to remain by your bedside for long stretches of time to ensure healthcare personnel follow your wishes. Under these circumstances, it may not be practical to have a representative who resides out of town.

You should discuss your healthcare wishes with your designated healthcare representative to ensure that he or she will be able to make decisions based on what you have discussed and the information contained in the directive.

Do I need to appoint an alternative healthcare representative?

You do not need to appoint an alternative healthcare representative however it is a good safeguard. Should your original representative be unable or unwilling to act on your behalf, your alternative representative could act for you instead.

When will my representative be allowed to make my healthcare decisions?

Your representative can only make your healthcare decisions after a doctor has determined that you are not capable of making or communicating responsible healthcare decisions for yourself.

Terminology
What is "life-sustaining treatment"?

Life-sustaining treatment is treatment which replaces, or supports, a bodily function which is not operating properly or failing. Where someone has a treatable condition, life sustaining treatments can be used temporarily until the body can resume its normal function again. However, sometimes the body will never regain that function.

What is "cardio pulmonary resuscitation (CPR)?"?

Cardio Pulmonary Resuscitation (CPR) is an emergency manoeuvre which is applied directly to the chest of a person whose heart has stopped. It manually preserves brain function until further measures can be taken to restore regular blood circulation and breathing.

Organ Donation
Can I specify organ donation in my Advance Healthcare Directive?

Yes. You may specify whether you want to donate certain organs or all organs.

Modification and Revocation
Can I change or alter my Advance Healthcare Directive?

If you wish to alter the directions in your Advance Healthcare Directive or appoint a different designated healthcare representative, you should destroy all copies of the directive and create a brand new directive. Remember that your directive should always reflect your current wishes. Also, ensure that you provide a copy of your new directive to your designated healthcare representative, your physician and anyone else you have selected to share it with.

Can I revoke my Advance Healthcare Directive?

If you wish to revoke your Advance Healthcare Directive, the best way to do so is by destroying all copies of the directive and notifying your healthcare provider of your decision. You may also revoke your directive by informing your attending physician or healthcare provider that you wish to revoke your directive. Generally, a revocation of an Advance Power of Attorney will only be accepted if the revocation was made while the directive-maker was of sound mind.

Miscellaneous
Signing Details
What should I do with my Advance Healthcare Directive once it has been properly signed and witnessed?

You should discuss your Advance Healthcare Directive with your designated healthcare representative, your family and your family physician. Additionally, you should provide these parties a copy of your directive.

Are there any other witnessing formalities?

Both of your witnesses must watch you sign, or they must both be present when you acknowledge your signature. Also, your witnesses must watch each other sign.

 

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