End of life guidelines drawn up

By Anthony Barich
National Reporter
ST JOHN of God Health Care and MercyCare WA have drafted new guidelines for patients planning future healthcare to cater for the WA Government’s Living Wills law set to come into effect on 15 February.

The guidelines were drawn up by SJOGHC and MercyCare Ethics Committees’ chairs Professor Con Michael and Mrs Maureen Colgan, respectively, Minter Ellison lawyer and former nurse Wendy Meggison, LJ Goody Bioethics Centre director Fr Joseph Parkinson and clinical nurse managers from the two healthcare bodies. The guidelines closely follow the ‘Guide for People Considering Their Future Health Care’ jointly published by the Australian Catholic Bishops Conference and Catholic Health Australia several years ago.
They will apply to Mercy Hospital in Mt Lawley and SJOGHC’s four hospitals in WA and 10 hospitals in NSW, Victoria and Christchurch. The booklet, to be distributed to rooms of specialists, GPs and referring doctors around WA and given to patients with hospital admission forms, will be printed once all the concerned hospitals have approved it and a link has been provided by the WA Health Department.
The push for Living Wills legislation stems from Austin Hospital in Heidelberg, Victoria, which in 2002 introduced Respecting Patients’ Choices, a pilot programme supporting advanced care planning that has since been extended to a number of other hospitals and communities around Australia, including Fremantle Hospital.
The guidelines are aimed at patients who may present an Advanced Health Directive (AHD), an Advanced Care Plan (ACP) or Enduring Power of Guardianship (EPG) upon admission into hospital.
Catholic healthcare, they say, is founded on the belief that life is a gift from God, and while patients’ personal preferences will be respected, patient care will always comply with Catholic ethical standards.
“This legal framework (the amended Consent to Medical Treatment Act) is supported by Catholic healthcare because it is about the promotion of autonomy and dignity. It is not about euthanasia,” the guideline states.
When patients may not be able to make a decision on future healthcare, they are encouraged to appoint someone they trust and have consulted to make a decision for them in accordance with their preference.
The ACP is not legally binding, while the AHD is binding if it complies with all requirements of the new law. The AHD and EPG must be made in accordance with WA legislation.
A sample of the ACP, which is to be discussed with the doctor and the enduring guardian or responsible person and is designed to guide but not direct future care, will be downloadable from the LJ Goody Bioethics Centre website.
This also follows the Australian Catholic Bishops’ Guidelines.
The ACP, written by the aforementioned parties, and which the patient signs, says: “I wish to be given appropriate care to sustain my life, to cure disease or reduce deterioration in any physical or medical condition that I suffer. I want effective, non-burdensome treatment and care.
“I do not want my life to be ended or my death to be hastened by any act or omission that is intended to cause my death. I wish to be offered food and drink (and) to follow the teachings of (whatever) church/religion and request appropriate ministry throughout my illness. I (want) access to palliative care that will address my physical, emotional and spiritual needs while maintaining as much function as possible during the process.”
The guidelines also list treatment options and examples of life-sustaining measures which the patient can decide to use or refuse, including CPR, renal dialysis, tube feeding, mechanical ventilation, blood transfusions, surgical procedures and intravenous antibiotics.
Patients are encouraged to record what they want and do not want to be done to them.