An Advance Decision to Refuse Treatment, sometimes called a living Will, lets you record medical treatments you would not want to receive in the future.
It only applies if you later lose mental capacity and cannot make or communicate the decision for yourself.
Making an Advance Decision can give doctors, relatives, and carers clearer guidance at a difficult time.
Creating an Advance Decision is free with By The Willow. We believe everyone should be able to record important treatment wishes without cost being a barrier.
An Advance Decision is a way to refuse specific medical treatment in advance.
It is used only if, at the time the treatment decision needs to be made, you lack mental capacity or cannot communicate your decision.
It is not the same as an Advance Statement. An Advance Statement records preferences and wishes about care, but an Advance Decision can refuse treatment in a legally binding way where the legal requirements are met.
In England and Wales, an Advance Decision is legally binding if it is valid and applicable to the treatment and situation in question.
In Northern Ireland, advance refusals may also be legally recognised under common law if valid and applicable.
In Scotland, advance statements and advance directives are not treated in exactly the same way as under the Mental Capacity Act in England and Wales, but doctors should take clearly recorded wishes into account.
Wherever you live, it is helpful to write your wishes clearly and share them with the people involved in your care.
An Advance Decision only applies if you cannot make or communicate the decision yourself at the relevant time.
For example, this might happen after a serious accident, during advanced illness, after a major stroke, or because of a condition that affects decision-making.
If you still have capacity to make the decision, your current decision will be followed instead.
People make Advance Decisions for different reasons.
You may want to:
◆ Refuse treatment that would artificially prolong life in certain circumstances
◆ Stay in control of important treatment decisions
◆ Make things clearer for your family
◆ Prepare after a diagnosis or long-term condition
◆ Record wishes while you are well and able to decide for yourself
Many people make an Advance Decision before they are seriously ill, simply because they want their wishes to be known.
For an Advance Decision to be valid, you must have had mental capacity when you made it.
It should clearly explain:
◆ Which treatment or treatments you are refusing
◆ The circumstances where the refusal should apply
◆ That you were not pressured into making it
◆ That you have not later done anything clearly inconsistent with it
If the Advance Decision refuses life-sustaining treatment, extra requirements apply.
It must be in writing, signed, witnessed, and include a clear statement that the refusal applies even if your life is at risk.
Add a Professional Review For £30, a specialist can review your completed Advance Decision before signing and help check for clarity, consistency, and common mistakes. Review my document
You can use an Advance Decision to refuse specific medical treatments, including life-sustaining treatment.
Life-sustaining treatment may include:
◆ Cardiopulmonary resuscitation, also known as CPR
◆ Mechanical ventilation or breathing support
◆ Clinically assisted nutrition and hydration
◆ Antibiotics for life-threatening infections
Some people want to refuse all life-sustaining treatment in specific circumstances. Others only want to refuse certain treatments in certain situations.
The more specific and clear your wording is, the easier it is for doctors to understand whether it applies.
Anyone aged 18 or over with mental capacity can make an Advance Decision in England and Wales.
The usual steps are:
◆ Think carefully about the treatments and situations you want to cover
◆ Write the decision clearly
◆ Sign and witness it properly, especially if it refuses life-sustaining treatment
◆ Share copies with the right people
◆ Review it regularly
You do not need a solicitor to make an Advance Decision, although you may want advice if your wishes are complex or there is likely to be disagreement.
An Advance Decision is only useful if people know it exists and can find it when needed.
You may want to share a copy with:
◆ Your GP surgery
◆ Close relatives or friends
◆ Your attorney, if you have a Health and Welfare Lasting Power of Attorney
◆ Your local hospital or relevant care team
◆ Your local ambulance service, where they accept records of Advance Decisions
Ask your GP surgery to add it to your medical record, and follow up to check it has been recorded.
In an emergency, paramedics or hospital staff may not know you have an Advance Decision.
It can help to keep a copy somewhere obvious at home, carry a notice card, or make sure close relatives know where the original document is stored.
Some people also keep a clearly marked copy with other important documents so it can be found quickly.
Your Advance Decision should reflect the person you are today. If your health, beliefs, relationships, or treatment wishes change, it is important that your document can change with you.
With By The Willow's unlimited updates option, you can keep your Advance Decision current for £10 per year. This gives you the flexibility to return to your document, update your choices, and make sure your wishes still feel right.
After making an update, print the new version, sign and witness it properly, and replace old copies wherever possible so doctors, relatives, and care teams are working from your latest wishes.
◆ An Advance Decision lets you refuse specific medical treatments in the future
◆ It only applies if you lack capacity or cannot communicate the decision at the time
◆ In England and Wales, it is legally binding if valid and applicable
◆ Refusals of life-sustaining treatment must be written, signed, witnessed, and say they apply even if life is at risk
◆ You should share copies with your GP, relatives, and relevant care teams
Create your Advance Decision for free Record the treatments you would refuse in future and make your wishes easier for others to understand. Let's get started
Speak to our team
We make it simple to create and manage essential legal documents online.
By The Willow™ - Copyright
. All rights reserved.
By The Willow™, a trading name of LCR Group Holdings, provides access to self-service legal forms and information. By The Willow™ is not a law firm and does not provide legal advice. It is not a substitute for a qualified attorney’s advice.
