Adults will be able to appoint proxies to make health decisions

The UK government is to legislate to allow adults to appoint friends or relatives to take healthcare decisions for them if they later become too incapacitated to decide for themselves.

Under plans for England and Wales unveiled last week by the lord chancellor, Lord Irvine, any adult of full capacity will be able to draw up a continuing power of attorney authorising the chosen proxy to consent to or refuse treatment and to take a range of other decisions.

But a general authority to take healthcare decisions will not allow the proxy to authorise the withdrawal of artificial nutrition and hydration This power would have to be spelt out specifically.

Similar reforms are under consideration for Northern Ireland, and a bill to introduce broadly similar changes in Scotland has already been introduced in the Scottish parliament.

But the government has pulled back from legislating on living wills—advance directives on medical treatment—after proposals to do so proved controversial. The white paper outlining the plans points out that case law has already established that advance statements about health care are legally enforceable.

The paper adds: “The government is satisfied that the guidance contained in case law, together with the code of practice, Advance Statements about Medical Treatment, published by the BMA, provides sufficient clarity and flexibility to enable the validity and applicability of advance statements to be decided on a case by case basis.”

In England and Wales a new Court of Protection, headed by a senior judge, will take treatment decisions that now go to the High Court's family division. The court will be able to appoint a “manager,” who could be a doctor, to take healthcare decisions, but the government expects that most treatment decisions will be “one-offs” and taken by the court.

• The law on damages for personal injury should be changed to allow the NHS to recoup the cost of treating people injured through negligence, the Law Commission recommended this week. This would go much further than the right the service already has to recover the costs of treating road accident victims.

Lord Irvine proposes proxies for medical decision making.

(Credit: PA NEWS)