Humanists Malta has put forward a discussion paper on legally binding Living Wills.
Living Wills would enable willing adults to give instructions about the medical care which they consent to or reject if they are unable to make or communicate decisions at the relevant time, Humanists Malta told The Independent. This would not be applicable for any treatment such as assisted dying, which is contrary to law, they said.
Chairperson Christian Colombo and committee member Joanna Onions from Humanists Malta expressed their plea for a discussion on Living Wills, which would propose legislation that would allow Maltese citizens to register a notice of their wishes about medical treatment (if they are not able to at the time of the treatment): "just as everyone has the human right to consent to, or reject medical treatment, they should also have a right to record binding decisions for future use," their website reads.
The proposal also states that the patient can specify that the responsible doctor can make all treatment decisions on their behalf, or simply that they wish their life to be prolonged to the greatest extent possible regardless of their condition or chances for recovery. Furthermore, the responsible doctor would be able to, in agreement with a designated proxy/executor if relevant, disregard the Living Will if it is incongruous. For example, if its contents are contradictory, not relevant, or of dubious legality until advice is obtained, or the subject has a high chance of full recovery.
Joanna Onions remarked that at times, Living Wills are misinterpreted or misjudged as euthanasia debates: "a living will simply extends a person's existing right to accept or reject legitimate treatment to circumstances in which they can no longer communicate their wishes." Onions also remarked that any illegal instructions in the will could not be legally enforceable.
She argued that they can't claim to have all the answers on Living Wills; "there are varying legal models in other countries, which would require expert legal analysis to decide which would be applicable in Malta." Humanists Malta aims to promote discussion, such as the exact definition of a medical intervention aimed at prolonging or sustaining life, "allowing medical professionals to have a clear framework, and patients to know which treatments they might choose to accept (such as pain relief, palliative care), or reject (such as resuscitation)." Other issues such as medical ethics ought to be discussed, including the question of conscientious objection, they said.
Asked why such legislation should be legally enforceable, Onions said: "It seems there is a risk that medical professionals might face legal action if they act by the patient's wishes, for example from relatives who did not agree with their loved one. A legally binding document would protect that wish, and provide more certainty for doctors faced with dilemmas at critical times."
Onions also shared her experience with Living Wills: "I have written a living will even though it has no legal standing here. I don't want to be kept alive in boredom, indignity or disability, without my independence. I don't want to go through the extended, sometimes debilitating, treatments, lack of quality of life, and slow death that my husband had, and bore so bravely for my sake, in his final months. And I don't know anyone with whom I would feel any comfort going through that with me the way I - more than willingly - went through it with him. Of course, others in other situations will feel differently, but I know what I want."
Humanists Malta urges that a serious discussion is due, calling on doctors, notaries, philosophers, and other stakeholders to contribute to the discussion.