Ireland's Assisted Decision Making Capacity Act-the potential for unintended effects in critical emergencies: a cross-sectional study of Advanced Paramedic decision making

Irish Journal of Medical Science
Gerard BuryMairead Egan

Abstract

Irish legislation on Advance Healthcare Directives (Assisted Decision Making Capacity Act 2015, ADMC) proposes to change the basis of decision making from acting in the patient's best interests to following the expressed will and intentions of the patient. Refusal of life-saving care can occur, without sound reasons. The implications for care in life-threatening emergencies have not been explored among clinicians. An anonymous questionnaire survey of Advanced Paramedics (AP) covering awareness of the legislation, attitudes to and experience of refusal of care and potential actions in emergency scenarios now and if the legislation were in force. The scenarios covered end-of-life and deliberate self-harm situations potentially requiring resuscitation. All 482 graduates of the Advanced Paramedic Training Programme were invited to take part. Overall, 85/389 (21.9%) valid contacts responded, with demographic characteristics similar to the overall population. Attitudes ranged from highly positive to highly negative in relation to the potential impact of the legislation on professional and operational responsibilities. Respondents described marked changes in whether they would offer resuscitation if the ADMC were in place. Irish legis...Continue Reading

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Jul 16, 1994·BMJ : British Medical Journal·R Gillon
Feb 21, 2002·Lancet·UNKNOWN Medical Professionalism Project
Feb 14, 2012·The Journal of Emergency Medicine·Rachel WaldronDeborah Mogelof
Jun 1, 2017·Annals of Emergency Medicine·Catherine A MarcoUNKNOWN ACEP Ethics Committee

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Citations

Aug 1, 2020·Nursing & Health Sciences·Ryan BennettBrett Williams

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