LPAsLife Sustaining Treatment

One of the most important questions a person is asked to consider when making a Health & Welfare Lasting Power of Attorney (LPA) is who should have the power to make decisions about their life sustaining treatment. This power can be given to the attorneys or left solely in the hands of the doctors treating them. Before making that decision though we need to appreciate what ‘life sustaining treatment’ is and what else we can include in an LPA to control the decisions an attorney can make.

What is life sustaining treatment?

Life sustaining treatment is any treatment that a doctor or healthcare professional considers necessary to keep the donor alive. What is actually covered can vary from case to case but can include:

• Lifesaving surgery, such as a heart bypass
• Organ transplants
• Artificial hydration and nutrition
• Cancer treatments
• Antibiotics, for example if the donor has pneumonia

What can be put in the LPA?

The donor of a LPA for Health and Welfare has two initial choices regarding life sustaining treatment. They can choose to give their attorneys the authority to make life sustaining treatment decisions in the LPA (option A) or alternatively can refuse to give the attorneys that authority (option B).

If option B is chosen it will be down to healthcare professionals to make decisions on the donor’s life sustaining treatment, (subject to any applicable advance decision of the donor if any). In the event of any doubt on which option the donor has selected, the Office of the Public Guardian will consider that Option B has been selected.

If option A is selected, the donor could either let the attorneys make these decisions as they see fit or alternatively the donor can include instructions and preferences in the LPA to guide the attorneys.

For example, the donor could include instructions that state:

• The attorneys must not agree to any life sustaining treatment if the donor is in a permanent or persistent vegetative state
• Circumstances in which they would not like to be resuscitated

The LPA could contain the following as preferences:

• If the donor is in the last states of a terminal illness, they would only wish for treatment to make them comfortable and would not like treatment that would prolong their life.
• If the donor has any preferred treatments that they would like to receive, for example they would like experimental treatments.

The above is not exhaustive and if the donor has any particular wishes, feel free to include these in the LPA instruction and we can advise on whether this would be possible. Including instructions or preferences is purely optional and if the donor does not wish to include any, they do not need to.