1. Care, carers, doctors… and the law? Michael Eburn School of Law University of New England.

2. Dementia Care Education Project27 October 2000 The role of the carer in medical decision making. Obligations of health care professionals. Rights and responsibilities of carers.

3. Dementia Care Education Project27 October 2000 The law and care Law as legislation. Common law. Law as litigation (going to court).

4. Dementia Care Education Project27 October 2000 Health professionals and patients An obligation to act in the patient’s best interests. An obligation to take reasonable care. An obligation not to provide care without the patient’s consent where the patient is capable of giving consent. An obligation to keep confidential anything that is told to them in confidence.

5. Patient or person in need of care CarerHealth Professional

6. Dementia Care Education Project27 October 2000 The first problem that a health professional may face is deciding whether or not a person is competent and then dealing with a carer who may have a different view, or who may want to make decisions on behalf of the patient/person in need of care.

7. Dementia Care Education Project27 October 2000 Competence Is she capable of comprehending and retaining information about the proposed treatment? Is she capable of believing the information given to her about treatment? Is she capable of weighing such information in the balance to make a choice?

8. Dementia Care Education Project27 October 2000 In Re F Care is reasonably necessary in the best interests of the patient. The most appropriate person provides the care. The care is not contrary to the known wishes of the patient.

9. Dementia Care Education Project27 October 2000 The second problem may be that the carer wants information about the patient/person in need of care that the doctor may feel obliged not to disclose.

10. Dementia Care Education Project27 October 2000 The health professional may be faced with a number of alleged carers.

11. Dementia Care Education Project27 October 2000 Rights and responsibilities of carers Q:Who is the carer? A:The ‘person responsible’ as defined in the Guardianship Act 1987 (NSW).

12. Dementia Care Education Project27 October 2000 ‘Person Responsible’ means: The person’s guardian. The person’s spouse. A person who has the care of the person. A close friend or relative.

13. Dementia Care Education Project27 October 2000 The ‘person responsible’ may Give consent for medical or dental treatment. Receive medical information.

14. Dementia Care Education Project27 October 2000 A carer may Be consulted on health issues provided –It is consistent with the purposes of providing health care to the person, and –The patient does not object

15. Dementia Care Education Project27 October 2000 Guardians Appointed under the Guardianship Act 1987 (NSW). Different from an Attorney. Attorney deals with financial and property matters. Enduring Guardian- appointed by the person to deal with health matters.

16. Dementia Care Education Project27 October 2000 Conclusion ‘… starts with a right of control and ends with little more than advice.’

17. CompetentIncompetent Can the carer consent to medical treatment? No.Yes if ‘person responsible’. Can the carer be consulted on health matters? Yes, if consistent with patient’s wishes and necessary to facilitate health care. Yes. Can a person who has Power of Attorney consent to medical treatment of another? No.

18. Dementia Care Education Project27 October 2000 Thank you for your attention.