An Advance Decision to Refuse Treatment lets you record medical treatments you would not want to receive in the future.
It is sometimes called a living Will, advance directive, or ADRT. It is designed to apply if you later lose mental capacity and cannot make or communicate the decision for yourself.
The legal effect of an Advance Decision depends on where in the UK you live.
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 document that refuses specific medical treatment in advance.
It can include life-sustaining treatment, such as CPR, ventilation, clinically assisted nutrition and hydration, or other treatment that may prolong life.
It does not let you demand treatment. Doctors still need to decide what treatment is clinically appropriate.
Yes, if it is valid and applicable.
In England and Wales, Advance Decisions are covered by the Mental Capacity Act 2005. If the Advance Decision meets the legal requirements and applies to the situation, health and social care professionals must follow it.
It will only be used if you lack mental capacity to make or communicate the treatment decision at the time it needs to be made.
An Advance Decision is more likely to be valid if:
◆ You were aged 18 or over when you made it
◆ You had mental capacity when you made it
◆ You were not pressured into making it
◆ You clearly identified the treatment you want to refuse
◆ You clearly explained the circumstances where the refusal should apply
◆ There is no reason to believe you have changed your mind
An Advance Decision must also be applicable. This means it must match the treatment and circumstances you are facing.
For example, if you refused ventilation in specific circumstances but did not refuse CPR, your Advance Decision may not apply to CPR.
If an Advance Decision is valid and applicable, doctors and care teams in England and Wales must follow it.
However, they may need to make a judgement about whether the document applies to the exact treatment and circumstances in front of them.
This is why the wording should be clear, specific, and kept up to date.
Keep your wishes up to date For £10 per year, you can update your Advance Decision whenever your health, wishes, relationships, or circumstances change. Update my document
Scotland has different rules from England and Wales.
Advance directives and advance statements can provide important evidence of a person's wishes. Health professionals should take those wishes into account when making decisions.
They are not treated in exactly the same way as Advance Decisions under the Mental Capacity Act in England and Wales, so if you live in Scotland, it is sensible to get Scotland-specific guidance.
Northern Ireland does not follow the same Mental Capacity Act framework as England and Wales for Advance Decisions.
However, a clear and specific advance refusal may be recognised under common law if it is valid and applicable.
Because the legal framework is different, it is sensible to make the document as clear as possible and seek local guidance if your wishes are complex.
An Advance Decision may not be valid if there is reason to believe you have changed your mind.
This could happen if you withdraw it, make a new document, give someone authority under a Health and Welfare Lasting Power of Attorney that conflicts with it, or act in a way that is clearly inconsistent with the decision.
Keeping your Advance Decision reviewed and up to date helps reduce uncertainty.
Mental capacity means being able to make the relevant decision at the time it needs to be made.
A person may lack capacity if they cannot understand, retain, use or weigh the relevant information, or communicate their decision.
Capacity is decision-specific. Someone may be able to make some decisions but not others.
◆ In England and Wales, an Advance Decision is legally binding if valid and applicable
◆ It only applies if you lack capacity to make or communicate the decision at the time
◆ Life-sustaining treatment refusals must be written, signed, witnessed, and say they apply even if life is at risk
◆ Scotland and Northern Ireland have different legal frameworks
◆ Clear wording and regular reviews make it easier for care teams to understand your wishes
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.
