LRC Report on Vulnerable Adults and the Law

LAW REFORM COMMISSION PUBLISHES REPORT ON VULNERABLE ADULTS AND THE LAW

Monday, 18 December 2006: The Law Reform Commission’s Report on Vulnerable Adults and the Law will be formally launched by the Minister for Health and Children, Mary Harney TD, this evening.

Background to Report
This Report forms part of the Commission’s Second Programme of Law Reform 2000-2007, which deals with ‘Vulnerable Adults and the Law’ under two related headings: the law and older people; and the law concerning adults whose ability to make decisions may be limited, for example, through intellectual disability, dementia or an acquired brain injury (such as in a car crash). The Report brings together these two areas and builds on two Consultation Papers published by the Commission, a Consultation Paper on Law and the Elderly (2003) and a Consultation Paper on Vulnerable Adults and the Law: Capacity (2005). The Report contains the Commission’s final recommendations on these areas and includes a draft Scheme of a Bill to implement them.

Main elements of the Report
The Report is divided into two parts. The first part recommends the enactment of a new mental capacity law to create clear rules on when a person has the legal competence (capacity) to make a wide range of decisions, including making contracts such as buying groceries at a shop, transferring ownership in land or making healthcare decisions. The second part recommends that the current Wards of Court system should be replaced by a new Guardianship system.

Empowerment and protection
In the Report, the Commission aims to promote the empowerment of vulnerable adults, while also recognising that some protections are still needed. In terms of empowerment, the Commission recommends that the proposed law should include a clear presumption that all people over 18 should be presumed to have mental capacity. The Commission also recommends that a modern “functional” approach to legal capacity should be put in place. The functional approach means assessing a person’s decision-making ability in relation to a particular decision at the time the decision is made.

Protection: equity release schemes
But the Commission also recognises that vulnerable adults may still need protection against abuse. For example, the Commission has recommended that all types of equity release schemes – many of which are aimed at older people – should come under IFSRA, the Financial Regulator. Some equity release schemes have been designed so that they are not financial products, so that IFSRA cannot currently regulate these types of schemes.

Healthcare decisions and informal authority to act
The Commission also makes specific recommendations in the healthcare context. At present, many routine health care treatments – such as dental treatment – are carried out for adults who have limited or no capacity on the basis of "consent forms" signed by a relative. These consent forms have no legal standing, and technically they could be regarded as assaults. The Commission recommends that this should be dealt with by stating in the proposed law that such routine treatments are lawful if they are clearly in the person’s best interests: this is called an informal authority to act. The Commission also recommends that the Minister for Health and Children could appoint a Working Group on Capacity to Make Healthcare Decisions to formulate a code of practice for healthcare professionals. The code of practice would provide guidelines on assessing a person’s capacity to make a healthcare decision and on the situations where treatment can be carried out under the proposed informal authority to act.

Enduring powers of attorney
The Enduring Powers of Attorney Act 1996 allows a person who currently has mental capacity to appoint someone (such as a spouse or partner) to make decisions on their behalf: the power of attorney only comes into force when the person loses capacity, for example, through dementia. The 1996 Act is currently limited to financial matters only. The Commission recommends that the 1996 Act should be extended to include minor health care and treatment decisions.
Guardianship system to replace Wards of Court The current institutional framework for protecting people with limited (or no) mental capacity – the High Court Wards of Court system - is also in need of reform. The Wards of Court system is governed mainly by the
Lunacy Regulation (Ireland) Act 1871, which states that a person can only be made a Ward of Court if they are a deemed to be a 'lunatic, idiot or person of unsound mind.' As well as using objectionable and outdated language, the Wards of Court system uses an "all-or-nothing"
approach to capacity: if the person is made a Ward of Court, they lose control over all aspects of their financial and personal life. The Commission recommends that this system should be replaced by a new decision-making structure, called Guardianship. This would involve the creation of Guardianship Board, which would make decisions about whether a person does or does not have continuing capacity to make key decisions about themselves. This could include deciding that a Personal Guardian should manage a limited aspect of the person’s financial affairs, but not necessarily everything. The Commission also recommends establishing a new independent Public Guardian.

The new Guardianship system
The Guardianship Board would be a three person full-time multi-disciplinary Board (along the lines of the Garda Síochána Ombudsman Commission), chaired by a High Court judge. The Board could make Guardianship Orders and Intervention Orders. Where a Guardianship Order is made, a Personal Guardian could be appointed over the property, financial affairs and welfare of a person who lacks capacity, whether in a limited way or more generally. An Intervention Order would be made for a specific purpose (such as ordering a once-off service), where a Guardianship Order would not be required. The Commission also recommends the establishment of the Office of Public Guardian, which would have a supervisory role over personal guardians and those acting under enduring powers of attorney. The Public Guardian would also have the power to develop and publish suitable codes of practice and have an educational role in this area, acting in cooperation with other bodies, including the National Disability Authority and the Health Service Executive.

Full text of report:
www.lawreform.ie/publications/reports.htm