BACK DOOR EUTHANASIA; Controversial Proposals to Allow Patients to Speed Up Dying Process - by Refusing Medical Treatment; Is This Improving Patients' Rights? Critics Fear Sick May Change Minds over Living Wills

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Byline: Petrina Vousden Health Editor

PATIENTS will be given the right to refuse treatment to keep them alive, under proposed laws.

The plans for so-called living wills would cement adults' rights over their choice of hospital treatment.

But critics expressed fears that patients who had made such living wills might change their minds when incapacitated.

The Law Reform Commission, which outlines its recommendations in a report today, wants to establish exactly which treatments patients can legally deny. At present, the law is not clear on just how closely doctors can adhere to a patient's requests.

It does not propose to alter existing laws banning euthanasia and assisted suicide - but patients could refuse treatment intended to sustain or prolong life, although this type of directive would have to be given in writing and witnessed.

The Commission is an independent body established in 1975 to make recommendations to the Minister for Justice 'so that the law reflects the changing needs of Irish society'. Its recommendations carry significant authority and are generally adopted as Government policy. The Commission said there was a need for those who want to make written or oral directives about the refusal of treatment, in advance.

Patients will be able to make care directives known as 'living wills' to give their views on future treatments they may have to have.

It will allow them to specify that they do not want certain treatment - for instance, 'I do not wish to be resuscitated' or perhaps simply, 'I do not wish to receive a flu injection'. It will also allow a person to refuse t r e a t m e n t on r e l i g i o u s grounds.

However, patients will not be allowed to refuse basic care like warmth, shelter, oral nutrition and hydration.

Labour health spokesman, Jan O'Sullivan, said the proposals appeared to be a step forward for patients .

'I personally favour this area being legislated for. I think people should have the right to decide the type of treatment they received, assuming that they are mentally able to make that decision.' The Commission is also calling for a statutory code of practice for doctors, containing guidance on when artificial nutrition might be considered basic care and when it could be considered 'artificial lifesaving treatment'.

And its research director Raymond Byrne said that the proposed law changes would not apply to parents refusing life-saving treatment for their children. In 2006, a High Court judge ruled that doctors at a Dublin maternity hospital could force a seriously ill 23-year-old Congolese woman, who was a practising Jehovah's Witness, to have a blood transfusion despite her refusal on personal and religious grounds.

The hospital took the action against the woman, who suffered a haemorrhage after a difficult birth that endangered the mother and child.

The woman later sued the State for E2million but lost.

In 2008, Judge Laffoy herself ruled that the Master of Holles Street hospital could administer a blood transfusion to the twins of a severely anaemic Jehovah's Witness mother as soon as they were born.

Jehovah's Witnesses believe the Bible prohibits ingesting blood and that this includes the storage and transfusion of blood. …