Cayman Healthcare Consulting - Living Wills and Advanced Directives Do Not Exist in the Cayman Islands

By: Barrie Quappé MPA, RN, BSN – Consultant/Director:

Are you aware that there is no legislation that provides a legal pathway for Living Wills or Advanced Directives in the Cayman Islands? Good news is, according to our Acting Medical Director: “At present, a document has been prepared and forwarded to the LA. It is my understanding that the document would soon be up for public consultation.” I do not know what the timeline is for this. Regardless, I wanted to raise awareness of this important issue.

Why should this matter? We have read news stories from other countries of elder abuse, ridiculously poor residential care of the elderly and of course the stress it places on large families when the ill family member can no longer communicate their wishes for their hospital care or end-of-life care.

A couple of quick examples:

  • From the BBC news on 20 June 2018:

“Gosport hospital deaths: Prescribed painkillers ‘shortened 456 lives’.” In addition: “More than 450 patients died after being given powerful painkillers inappropriately at Gosport War Memorial Hospital, a report has found. An independent panel said, taking into account missing records, a further 200 patients may have suffered a similar fate.The report found there was a “disregard for human life” of a large number of patients from 1989 to 2000. They credit brave nurses who were whistle blowers and the affected family members who were initially disregarded when they expressed concerns.”


“Mid Staffordshire NHS trust left patients humiliated and in pain. Francis inquiry finds ‘shocking’ failures in care as hospital focused on cutting costs and hitting government targets.”

I don’t share these examples to scare, although they should. I share these to demonstrate that healthcare, like any other service can and does fail us. Sometimes, even with the most dedicated practitioners (such as the brave nurses we read about in the Gosport incidents), it is the hospital system itself and the decision makers who have been shown to have ignored patients and their families with a view to improving financial management.

Both examples are cautionary tales that everyone should pay heed to. But I digress and bring the focus back to Living Wills. Check out information online about Living Wills and Advanced Directives, there is a plethora. A good example can be found here.

I don’t know why our legislators have never dealt with this. Certainly, knowing what you want, and/or a family member wants (should they not be able to speak for themselves) would prevent a crisis for the family. Plus, the patient would have the comfort of knowing that their wishes are known to their family and to their healthcare providers.

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