Health care decisions at the end of life include all of the consent issues discussed in this section.
People are free to make treatment decisions, including at the end of their life, about what kind of health care treatment they wish to have or not have. The details discussed in the consent section therefore also apply to end of life health care decision making.
People at the end of their lives can also plan for times when they may be unable to consent. They may provide instructions for what they wish to happen (advance care planning), or they may appoint somebody they wish to make decisions for them (for example a guardian). If they have not appointed somebody, a substitute decision maker may be recognised at law, or appointed by the Court. The Court may also intervene if it is in the best interests of the patient to do so. Many of these principles are covered in the section on consent during times of incapacity.
If the patient at the end of their life is a child, parents may make most treatment decisions, provided they are acting in the best interests of the child. Older children, that have decision making capacity (known as ‘Gillick competence’) may also make treatment decisions for themselves. When the issue of what is in the best interests of a child arises, or whether the child has sufficient competence, the Court may again play a role. These issues are discussed in the section on consent for minors (children and young people).
However, there are also other treatment decisions, such as the withholding or withdrawal of life-sustaining measures, that may arise in relation to adults, and children, at the end of their life. The section on end of life provides an overview of legal issues surrounding such decisions, and in particular when and by whom they can be made.