The need for legislation in Ireland to recognise and enforce advance-care directives, or “living wills”, has been highlighted by a new study.

An advance-care directive is a statement about the type and extent of medical or surgical care a person wants at the end of their life if they are too ill or not in a position to make a decision for themselves at that time.

Dr Alice Coffey, lecturer in the School of Nursing and Midwifery at University College Cork, said while advance-care directives were legal in the US and other jurisdictions, there was no legislation providing for their enforcement in Ireland, where the issue was under discussion.

Prof William Molloy, who joined UCC as chairman of gerontology and rehabilitation in 2010, has a long history of research experience in the area of advance-healthcare directives in the US and Canada.

The results of a preliminary study involving Prof Molloy, among others, will be presented at the 11th annual Nursing and Midwifery Research Conference on Friday at UCC.

The survey of 102 nurses and midwifes and 151 doctors found the vast majority would recommend patients and other people to prepare an advanced-care directive, but most would feel more comfortable if there were no medicolegal implications.

The participants were given the scenario of an 84-year-old man with Alzheimer’s disease who had spent the past seven years in a nursing home, was unable to recognise anybody and had no family available. He had suffered three severe incidents of bleeding in the stomach and would most likely die.

They were asked to decide between three options: leave him in the nursing home and keep him comfortable with palliative care (least intervention); transfer him to hospital for a blood transfusion; transfer him to hospital for surgery and a transfusion or give him intensive care to maintain his life, including a ventilator (most intervention).

From the Irish Times, Tuesday 1st November, 2011