Group welcomes living will plans, suggests format
A living will should not apply only to end-of-life care, Humanists Malta says
An NGO representing humanists has backed government plans to introduce living will legislation and suggested how it should look like.
"It has long been internationally recognised that a patient has the right to consent to, or deny, medical treatment, and that doctors have the duty to respect their autonomy and dignity. An obvious extension of that principle is that people should have the right to make and record, in advance, decisions about their future healthcare," Humanists Malta said.
It recalled that it made proposals for the introduction of the living will in Malta in 2022, recognising the need for a clear legal framework to allow people to state their medical wishes in advance.
The group said the concept of a living will should not apply only to end-of-life care but should be a broader expression of a person’s preferences regarding medical treatment in situations where they are no longer capable of making or communicating decisions themselves.
"Some may wish for every possible medical intervention to prolong life, regardless of the prospects of full recovery. Some may want doctors to make all treatment decisions on their behalf. But some may prefer to refuse certain treatments if the likelihood of meaningful recovery is small. A Living Will allows each person to make these choices in advance, reflecting their own values and understanding of dignity and quality of life."
Humanists Malta said the right to make a legally-binding living will must be available to every mentally-competent adult, regardless of their current state of health.
The law on living wills should allow individuals to designate a trusted healthcare proxy (as is already the case in 11 other European countries) to make healthcare decisions on their behalf if unforeseen circumstances arise when they become incapacitated.
There should be a requirement that individuals preparing a living will do so only with confirmed guidance from a trusted medical professional. This would ensure decisions are informed by accurate medical understanding, and that patients are aware of the implications of the choices they make.
Living wills, the group said, should be subject to a periodic review, ideally every ten years. A review process would ensure that previously expressed wishes remain relevant in light of medical advances, and continue to reflect the individual’s current views.
The group said a national registry of living wills should be established, as in Denmark, Portugal, Spain and Italy, and it should be easily accessible to authorised medical practitioners. Without such a system, even the most carefully prepared document risks remaining unknown at the crucial moment it is required.