Advance Decisions

What is an Advance Decision?

An Advance Decision (sometime referred to as a Living Will) is a way for you to set down now the type of medical treatment you might refuse in the future. You must include all treatments you wish to exclude in the document drawn up.

The Advance Decision must be clear so if you want to refuse treatment in certain circumstances then you must clarify in the document to avoid uncertainty. It allows you to let your family, friends and medical professionals know your wishes if you are unable to communicate at the time the treatment is needed.


What happens if I  do not have an Advance Decision?

If you need medical treatment but cannot make a decision then the doctors in charge of your care or a decision-maker (such as an attorney under a Health & Welfare Lasting Power of Attorney), will make a decision in your best interests.

The doctor or decision-maker will look at the treatment needed and weigh up many factors to decide if the treatment is in your best interests. They will consider any views you have made known to them (if any) and also ask your family and friends. They will make the best decision they can in the circumstances.

If you have strong feelings about the refusal of medical treatment then it is best to set these out in an Advance Decision and this avoids confusion or uncertainty and ensures you can refuse treatment as you see fit.


What types of treatments does it cover?

It allows you to refuse any medical treatment such as Cardiopulmonary Resuscitation (CPR), being put on a ventilator, being given food or fluids artificially through a drip or a tube.


What doesn’t it cover?

It does not cover anything illegal such as help to end your life (Euthanasia and assisted suicide are illegal in England). It also does not cover refusing food or drink by mouth or being kept clean and comfortable. You cannot demand treatments under an Advance Decision, it is for Doctors to decide what is appropriate in your circumstances.


What form does it take?

The Advance Decision must be written down, signed by you and signed by a witness.


Is it Legally binding?

As long as it conforms with the legal requirements in that it complies with the Mental Capacity Act, it is valid and it applies to the situation then it is legally binding. It therefore takes precedence over any best interest decisions.

In order for the Advance Decision to be valid:

  • you must be over 18 years old;
  • specify clearly the treatments you wish to refuse;
  • explain the circumstances in which you would refuse treatment
  • you have made the Advance Decision of your own free Will
  • it is signed and witnessed
  • You have not said or done anything since signing it to contradict the Advance Decision (i.e. telling people that changed your mind)


Is it the same as a Lasting Power of Attorney for Health and Welfare?

No. Attorneys under a Lasting Power of Attorney for Health and Welfare can make decisions about anything to do your health and personal welfare. This includes decisions about medical treatment.

But, when it comes to  refusing life-sustaining treatment, the attorney must have been given permission to make these decisions when the LPA was made. They will be the one making decisions in your best interests. It is best to make a separate Advance Decision which the attorney can follow.


If you would like more information or  assistance with making an Advance Decision, then please contact Esther Janalli-Brown on 01306 884432 or email for more information.