04.05.02.01. Provisions exist which promote supported decision-making, which enable people with and without dementia or network of persons to discuss issues and make decisions | New Zealand

04.05.02.01. Provisions exist which promote supported decision-making, which enable people with and without dementia or network of persons to discuss issues and make decisions | New Zealand

15 Sep 2022

Yes

As described by Iris Revuecamp in her essay “Plugging the gaps – Strengthening the rights of mentally incapacitated adults pending substantive law reform” (Human Rights Commission, 2018).

There are, in essence, two components to the current legal framework as it relates to healthcare decision-making where an adult does not have capacity to make decision(s) – where a competent adult has made an advance decision relating to the provision of future healthcare, should particular circumstances arise (an advance directive); and where another individual supports an adult to make a decision, or makes a decision on behalf of that person, if they themselves lack the capacity to do so. The law in New Zealand only allows certain people to make decisions on behalf of mentally incapacitated adults. These are limited to attorneys appointed under Enduring Powers of Attorney (EPOAs); providers of health and/or disability services (in certain limited circumstances); court appointed welfare guardians or property managers; other persons appointed by the Court for specific purposes; and/or the Court.

There are several concerns arising from the operation of the framework which applies to EPOAs. These include a lack of knowledge and understanding of EPOAs by both those working with, and those acting as, EPOAs;14 a lack of detailed guidance or support available to EPOAs or those working with EPOAs;15 an absence of a quick and simple mechanism to challenge decisions made or actions taken by an EPOA,16 and the lack of monitoring of EPOAs (p39).

References:

Human Rights Commission. (2018). This is not my home: A collection of perspectives on the provision of aged residential care without consent. Auckland Human Rights Commission.