Edinburgh Napier University

  Purpose
To inform those who are supporting persons who are dying and are responsible for planning, commissioning or delivering palliative care about the need to support and maximise the decision-making ability and choices of persons with advanced dementia or severe frailty.

Approach
This article will consider the legal and human rights principles applicable to Scotland, and indeed to other jurisdictions, which govern decisions about care and treatment of persons with and without capacity and the application of these principles to palliative care situations.

Implications
It is a well-established legal and human rights principle that the decisions of a person with capacity must be respected, including decisions about palliative care and treatment at the end of life. Moreover, recent developments in international human rights law reinforce the message that this principle applies equally to all. Applying this principle into persons with advanced dementia or severe frailty therefore requires skilled assessment and supported decision making in order to optimise capacity and respect autonomy.

Value
An awareness of the underpinning legal and human rights framework which underpins decisions made that concern persons with advance dementia or severe frailty and their palliative care respects and enhances their choices and dignity.