New health bill to provide for living wills

| 14/03/2019 | 22 Comments

Cayman News Service(CNS): Government has published a bill to address advance decisions about healthcare, particularly relating to end-of-life care and for those who become mentally ill, as no such law currently exists in Cayman. The Health Care Decisions Bill is expected to be debated at the next meeting of the Legislative Assembly, scheduled for 3 April, and provides a framework for advance healthcare directives, or living wills, where individuals’ wishes surrounding medical treatment can be set out before they become terminally ill or mentally impaired and ensure that patients retain their rights regarding healthcare decisions.

In the absence of such legislation, healthcare providers can face real challenges with families and caregivers of patients that cannot make decisions for themselves on what treatment should be provided. The proposed law would provide a mechanism for things like ‘do not resuscitate’ orders, or restrictions on invasive procedures and choices about the types of treatment a patient may or may not wish to undergo.

The new bill provides for advance directives to be made by people over the age of 18 who are mentally competent, and to appoint one or more proxies to act as a substitute decision maker if they become mentally incompetent, who would then act in alignment with the directive made by the patient before they become too ill or mentally impaired to decide.

Doctors can and do provide advice about care and treatment, but knowing a patient’s wishes in advance can smooth the process when it comes to end-of-life care and in other challenging circumstances. The law also provides guidance and protections for doctors and hospitals where patients are receiving care.

The legislation outlines the principles that are to be applied in relation to making decisions and orders in respect of healthcare directives and provides that decisions must be made based in the best interests of the person, except where a directive, proxy or order states otherwise.

It also sets out eight principles which must guide the making of a directive, which included that the directive-maker is a mentally competent adult, that the wishes of the directive-maker must be respected and are paramount and any directive must be validly made, as well as the formalities for the making of an advance healthcare directive.

It also makes clear that living wills cannot include anything unlawful or which would breach professional standards and reasserts that assisted suicide is not allowed.

The law paves the way for the creation of mandatory hospital ethics committees, their membership composition as well as their functions, including making decisions about care or treatment where there is disagreement over the interpretation of advance decisions or living wills.

See the full draft law in the CNS library

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Comments (22)

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  1. Anonymous says:

    In Cayman god rules. Nobody else.

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  2. Anonymous says:

    No recognition of the rights of a same sex spouse married abroad on health care issues though. Shame that religious bigotry is more important than health decisions and common decency.

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  3. Anonymous says:

    CNS, I clicked on the link and cannot find the the Draft Law?

    CNS: Scroll down to the “Health” section – Health Care Decisions Bill, 2019 (draft)

  4. Anonymous says:

    Just get on with it and PASS the @#$%%^& thing. Should have been done eons ago – and this needs to be just the beginning. Oh, and for pity’s sake keep the religious nut cases well away from this bill!!

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  5. Anonymous says:

    Hope it includes the right of a person to decide if/when they want to die with dignity when facing an incurable disease.

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    • Anonymous says:

      I think the Baby Jesus and our Loving Sky Fairy Father want to force us to carry on in excruciating agony, misery and distress. His will and all…

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  6. Void says:

    Donate my organs to those who need it to live, the remains to whatever science can benefit from, and whatever is left, cremate my ashes and spread it in soil so that I may return from where I came.

    We were all nothing but lifeless, soulless molecules scattered across the Earth before birth. That milk you drank last month imported from USA? Some of the Calcium molecules are now part of your bones. Think about it..

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  7. Anonymous says:

    They should be debating a law to mandate that all residents have to become a member of the Cayman Islands National Insurance Co., so that the company will have more funds to increase our our benefits. I am paying CI $ 501.00 per month and my benefit is between CI$ 400.00 / 600.00per year.. Unless we get some remedy We will all have no option but to go to NAU to get some assistance. I have heard them trying to justify the measly amount by saying we have to understand that it is not just CI$ 400-600 benefit but if we have to be hospitalized or flown out on air ambulance we would be covered. We need the coverage to enable us to be able to get the proper medical care so that we do not end up hospitalized or having to be flown out. Many of us have never been hospitalized besides when we were birthing our babies 30-50 years ago but as is normal we are aging and with thst comes health issues. Come on people make CINICO what it was envisaged to be, I,e, a national insurance.

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  8. Slacker says:

    At last! Get it passed as a matter of urgency. Then we can take on the assisted death issue.

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  9. Anonymous says:

    More committees!

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  10. Anonymous says:

    I’m guessing by this that there is no equivalent of the UKs ‘purple form’ over here. That allows patients to opt out of treatment in an end-of-life situation – effectively it’s DNR.

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    • Anonymous says:

      There is DNR.

      • Anonymous says:

        4:30 Are you sure? Because that’s not what I’ve been told by a nurse here. She says they’re told to carry on giving treatment as long as your insurance pays for it – bit like they tend to do in the USA.

  11. Anonymous says:

    More arbitrary moral policing by the state by not allowing euthanasia because apparently allowing people dignity in death is less important than assuaging the authoritarian right wingers in this country who believe their religion is the the law of the land

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  12. Anonymous says:

    World Class

  13. Anonymous says:

    Poorly drafted. It allows for a foreign law governed power of attorney to be recognised in the Islands? Not sure if anybody bothered to check the CI Power of Attorney law.

    Also primary laws do not set out principles. They are usually in schedules to the primary law.

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    • Anonymous says:

      Yes, when someone is ill and they have given a relative a power of attorney the priority has to be to defeat the wishes of the ill person because they have not spent money on a Cayman lawyer. That is a sensible set of priorities.

    • Anonymous says:

      For goodness sake! This is about health decisions, why should doctors care what law governs a power of attorney?

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