Caring for someone at the end of their life can be extremely challenging, both emotionally and physically. It inevitably involves death and in some cases suffering and discomfort. As a result, there is a range of important legislation in place to protect people who are dying, their families and any other people involved in their care and support.
The key areas of legislation are:
Mental Capacity Act 2005 (MCA)
The MCA applies to everyone involved in the care, treatment and support of people aged 16 and over. It is designed to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment.
The MCA puts the individual at the centre of the decision-making process. Service providers must show through their records how people are supported to stay in control of their lives and make their own decisions about how their care and support is provided.
The MCA allows people to express their preferences for care and treatment and to appoint a trusted person to make decisions on their behalf should they lack capacity in the future. This may become relevant towards the end of a person’s life if they cannot make decisions for themselves.
The MCA is relevant to every day practice and is not just for end of life care. This is a summary of what the MCA says which will relate to the work you do on a daily basis:
If you are concerned that a person who is dying shows a lack of capacity to make choices and decisions for themselves, you need to follow this guidance. You also need to record in the care plan and to let your manager know if there is a change, for example, someone who appears to lack capacity occasionally to someone who appears to lack capacity all of the time. This is a complex area in which you will need further training and support from your manager.
Independent Mental Capacity Advocate or IMCA
Under the Mental Capacity Act, the individuals you work with can be provided with an IMCA or someone they chose to act on their behalf, who will support them to make decisions on their behalf in certain situations.
Examples might be where a person needs serious treatment or where they might have significant restrictions placed on their freedom and rights.
Care Act 2014
The Care Act focuses on wellbeing and complements the Mental Capacity Act. It recognises the importance of beginning with the assumption “the individual is best-placed to judge their own situation.”
The Care Act places a duty on local authorities to make sure:
“Begin with the assumption that the person is best-placed to judge their situation”
Equality Act 2010
In their publication “A different ending: End of life care review”, the Care Quality Commission, state:
“People from certain groups in society are experiencing poorer quality care at the end of their lives than others because service providers do not always understand or fully consider their specific needs.
Some service providers might not be fulfilling their duties under the Equality Act 2010. All public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work.”
This highlights the importance of the Equality Act 2010 by making sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.
Assisted dying – IT IS NOT LEGAL!
Sorry for shouting but it’s really important that you know this.
Assisted dying is the term used for supporting or allowing a dying person to have the choice to control their death if they decide their suffering is unbearable. It has caused a lot of public debate, discussion and opinion surveys showing growing support for a change in the law on the right to die.
Euthanasia is the act of deliberately ending a person’s life to relieve their suffering. Depending on the circumstances, euthanasia is considered as either manslaughter or murder under UK law. The maximum penalty for someone deliberately ending a person’s life or supporting them to end their life is life imprisonment.
The Suicide Act 1961 and the Criminal Justice Act (Northern Ireland) 1966
These laws make it an offence to encourage or assist the suicide of another person in England, Wales and Northern Ireland. There is no specific prohibition of assisting a suicide in Scottish law, but anyone doing so could be charged with murder or culpable homicide.
You must never discuss suicide with anyone you support or care for. If they mention it to you, you should always report these comments immediately to your manager.
Assisting a suicide is a crime!
If you are convicted of assisting someone to die, you could face up to 14 years in prison.
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