Clarification re Next of Kin & Advanced Care Directives
A lot of people confuse the term “Next of Kin” as conferring the person named with the authority to allow or refuse treatments on behalf of a patient in the event they do not have the capacity to decide for themselves. This is not the case and ‘Next of Kin’ simply means someone who you would like contacted in an emergency. Being a ‘Next of Kin’ provides no legal standing whatsoever despite widespread belief to the contrary; beliefs held by some health and social care professionals as well as the general public.
In the context of the emerging public health emergency in which health and social care staff on the frontline will be under enormous pressure it is vital that their time is not wasted by pointless arguments among family members about ‘Next of Kin’. It is also important that hospital staff establish who the patient wants as their designated contact person NOW as opposed to insisting that someone who was listed as your ‘Next of Kin’ some years ago should remain as your designated person. In some cases this could mean an abusing family member.
To safeguard themselves in a healthcare situation, patients should be advised to state clearly:
- The name of an Emergency Contact / Designated Person who they would like contacted in the event of an emergency, serious illness or death.
- Who they are happy for information about their medical condition to be shared with
- Being clear on these two things and insisting that their wishes be so recorded can help minimise confusion, family tensions and wasting the time of overstretched health and social care professionals.
Patients should also consider Enduring Power of Attorney, Advance Healthcare Directives and Think Ahead, www.thinkahead.ie (a resource of the Irish Hospice Foundation which assists people to plan and record their wishes in the event of emergency, sudden illness or death). The Think Ahead form is available on this link: https://hospicefoundation.ie/wp-content/uploads/2018/10/Think-Ahead-May-2018-Logo-Change-only.pdf
The Assisted Decision-Making (Capacity) Act 2015 provides a legal framework for Advance Healthcare Directives in Ireland. The Act was signed into law on 30 December 2015 but has not yet been commenced to bring it into effect. An Advance Healthcare Directive, sometimes known as a ‘living will’, is a statement about the type and extent of medical or surgical treatment you want in the future, on the assumption that you will not be able to make that decision at the relevant time.
At present in Ireland, if a healthcare issue arises and the patient is incapable of making a decision, it is the practice to consult with close family members. It is not clear what legal basis there is for this, as family members have no general right to make decisions on behalf of adults. By completing the Think Ahead form and by notifying their GP/medical professionals about their wishes, patients can ensure their wishes are known to medical staff from the start.
An Advanced Care Directive LET ME DECIDE was piloted in County Cork earlier this year, although the pilot is on hold during Covid19. If you would like to know more about this project, please email firstname.lastname@example.org and we can help you complete this directive through online chat.