'Welfare attorney' to decide care
Updated on 01 April 2007
People will now be able to appoint a close friend or family member to make vital decisions on their medical treatment after new guidance was issued by the British Medical Association.
Anyone can appoint a welfare attorney to act on their behalf when they are no longer capable of making their wishes clear to doctors.
The guidance comes in a new edition of the BMA guide - Withholding and Withdrawing Life-Prolonging Medical Treatment - which takes into account new legislation under the Mental Capacity Act and comes into force on Sunday.
The BMA says everyone, young or old, is encouraged to talk about what they would like to happen if they are seriously injured or unwell and cannot communicate their wishes to doctors. The welfare attorney does not have to be a qualified lawyer - it can be anyone, such as a close friend or family member, who people think will best represent their wishes to medics.
The position is not like handing over power of attorney in financial affairs because the welfare attorney cannot make any decisions as soon as someone is taken ill, only when they are no longer capable of expressing themselves.
Dr Vivienne Nathanson, the BMA's head of science and ethics, said it was important for people of all ages to break the taboo of talking about death. She said: "We all need to think about talking about difficult issues. We need to break the taboo because it helps each other have more control."
The BMA says there are safeguards in place if a medic believes the welfare attorney is not acting in the patient's best interests.
If doctors have difficulties with the decisions made by the welfare attorney - for example, if they are motivated by the contents of a will or life insurance policy - they are legally obliged to take steps to bring the case to the court of protection, which will decide.
The welfare attorney will not be able to tell doctors how to treat a patient if a course of treatment is deemed medically unsuitable. Instead, they will be able to state the patient's wishes if offered different treatment options.
The first part of the legislation comes into force in England in April and the second stage in October, when people will be able to appoint a welfare attorney.
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