Call for a law to allow 'living wills'

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Nurses yesterday called for a law backing "living wills" to allow patients the right to "die with dignity". A majority of RCN delegates voted, three to one, to give patients the right to refuse treatment which artificially prolongs life, thus reversing previous union policy.

The decision brings the college into line with the British Medical Association and the Patients' Association.

Bob Hallawell, a nurse specialising in learning disabilities, said that people should be allowed in advance to forego treatment such as "invasive or painful therapies". Living wills, or "advance directives" as they are known in the medical profession, also allow patients to give their permission for treatment in advance, he said.

Delegates insisted they were not endorsing euthanasia - living wills provided for "inaction" rather than a positive act to end life. Mr Hallawell said it would not permit patients to ask others to do anything illegal.

The wills would allow those suffering from a mental disorder to decide their treatment in advance of a relapse, Mr Hallawell said.

In cases of intellectual deterioration the directives could be drawn up when the patient was capable of making the decision.

Mr Hallawell said the absence of legal status for advance directives often leaves healthcare professionals, carers and others "in positions of uncertainty, anxiety and conflict".

n Senior nurses with vital clinical experience are being made redundant as part of a drive to cut back on the "grey suits" and "paper shufflers" in the health service, according to the RCN.

In targeting National Health Service employees on more than pounds 20,000 a year, trusts are axing senior ward sisters, intensive-care staff and other specialist nurses, the college has discovered.

RCN delegates were told that the Government's policy of cutting management costs by 5 per cent was seriously affecting patient care. The college's national council was instructed by delegates to investigate the impact of the cuts on nursing.