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Published in: Irish Journal of Medical Science (1971 -) 1/2015

01-03-2015 | Review Article

The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy

Author: B. D. Kelly

Published in: Irish Journal of Medical Science (1971 -) | Issue 1/2015

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Abstract

Background

Ireland’s Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland’s outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review.

Aims

To explore the content and implications of the Assisted Decision-Making (Capacity) Bill.

Methods

Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature.

Results

The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for “dignity, bodily integrity, privacy and autonomy”. The Bill proposes legal frameworks for “assisted decision-making” (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her “will and preferences”); “co-decision-making” (where the Circuit Court declares the individual’s capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); “decision-making representatives” (substitute decision-making); “enduring power of attorney”; and “informal decision-making on personal welfare matters” (without apparent oversight).

Conclusions

These measures, if implemented, will shift Ireland’s capacity laws away from an approach based on “best interests” to one based on “will and preferences”, and increase compliance with the United Nations’ Convention on the Rights of Persons with Disabilities.
Appendix
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Footnotes
1
For relevant case-law relating to deprivation of liberty, see: HL v UK (Bournewood) (2004) 40 EHRR 761; DD v Lithuania (2012) ECHR 254; Stanev v Bulgaria (2012) EHRR 46.
 
2
Section 69 of the Mental Health Act 2001 reads: “(1) A person shall not place a patient in seclusion or apply mechanical means of bodily restraint to the patient unless such seclusion or restraint is determined, in accordance with the rules made under subsection (2), to be necessary for the purposes of treatment or to prevent the patient from injuring himself or herself or others and unless the seclusion or restraint complies with such rules. (2) The Commission shall make rules providing for the use of seclusion and mechanical means of bodily restraint on a patient. (3) A person who contravenes this section or a rule made under this section shall be guilty of an offence and shall be liable on summary conviction to a fine not exceeding £1,500. (4) In this section “patient” includes (a) a child in respect of whom an order under section 25 is in force, and (b) a voluntary patient”. Rules governing the use of seclusion and restraint are available on the website of the Mental Health Commission: http://​www.​mhcirl.​ie/​Mental_​Health_​Act_​2001/​Mental_​Health_​Commission_​Rules/​Seclusion_​and_​Mechanical_​Restraint/​ (website verified, 8 March, 2014).
 
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Metadata
Title
The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy
Author
B. D. Kelly
Publication date
01-03-2015
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 1/2015
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-014-1096-1

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