Kelly B D
Department of Adult Psychiatry, UCD School of Medicine and Medical Science, Mater Misericordiae University Hospital, University College Dublin, 62-63 Eccles Street, Dublin 7, Ireland,
Ir J Med Sci. 2015 Mar;184(1):31-46. doi: 10.1007/s11845-014-1096-1. Epub 2014 Mar 12.
Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review.
To explore the content and implications of the Assisted Decision-Making (Capacity) Bill.
Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature.
The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight).
These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.
爱尔兰的《辅助决策（能力）法案》（2013年）旨在改革与需要协助行使决策能力的人相关的法律。该法案最终确定后，将取代爱尔兰过时的法院监护制度，该制度对能力采取非此即彼的方法；没有充分界定能力；对变化反应迟钝；在任命决策者方面规定繁琐；且审查规定不足。
探讨《辅助决策（能力）法案》的内容及影响。
审查《辅助决策（能力）法案》的内容及相关文献。
新法案包括能力推定并对无能力进行了定义。所有干预措施都必须尽量减少对权利和自由的限制，并适当考虑“尊严、身体完整性、隐私和自主权”。该法案为“辅助决策”（个人自愿指定某人协助做出与个人福利或财产及事务相关的特定决策，包括通过协助个人表达其“意愿和偏好”等措施）、“共同决策”（巡回法院宣布个人能力降低，但他或她可与共同决策者共同做出特定决策以分享权力）、“决策代表”（替代决策）、“持久授权书”以及“个人福利事务的非正式决策”（无明显监督）提出了法律框架。
这些措施若得以实施，将使爱尔兰的能力法律从基于“最佳利益”的方法转向基于“意愿和偏好”的方法，并提高对联合国《残疾人权利公约》的遵守程度。
