What is an Advance Decision?
Preparing an advance decision allows you to set out your decisions and choices about refusing medical treatment in certain situations, should you lose the mental capacity to make these decisions in the future.
Advance decisions are often referred to as ‘living wills’. They are covered by the Mental Capacity Act 2005.
What can I set out in an advance decision?
By making an advance decision you can outline the treatment or procedures that you would want, or would not want, if you become seriously ill.
Some people may want to complete a DNACPR which stands for “Do not attempt cardiopulmonary resuscitation (CPR)”. Some people choose to have one simply because they do not want to be resuscitated in an emergency. In some cases, a healthcare professional or team might advise that someone is so unwell from an underlying illness, that CPR will not prevent their death. DNACPR only specifies whether a person will receive CPR or not. Patients will still receive appropriate treatment for their health issues and all personal care needs will be attended to.
Please note that it can not be used to:
- refuse basic nursing care, i.e. basic hygiene and pain relief;
- stop staff offering you food and drink by mouth; or
- request euthanasia or unreasonable treatment.
If you have an existing living will and have decided to keep it and not fill in a new Advance Decision, the least you must do to make it valid under the new law is to include the statement that:
“The decision should apply even if it results in the shortening of my life”
Then you must sign and date this addition, and have it witnessed.
Making an Advance Decision
Unless you wish to refuse life sustaining treatment, an advance decision does not have to be a written document. However, it is advisable to put your preferences in writing to ensure that your wishes are carried out. Where advance planning and decisions are being made a discussion is needed with your hospital clinician or GP, specialist nurse, to ensure you are correctly informed to make these decisions. To make an advance decision you must:
- be aged over 18 years old;
- be mentally competent and not suffering from any mental distress at the time the directive was drawn up;
- not be influenced or harassed by anyone else when preparing the directive; and
- appear to have been fully informed about the treatment options and their implications when the directive was made.
If the advance decision is a written document, it needs to be witnessed and signed by at least one person, who is not a spouse, partner, relative or anyone who stands to benefit from your will.
There is no official form or guidance to help you to prepare an advance decision, but there are several organisations that have produced their own versions to help you, including:
To prepare an advance decision you may wish to have help from a solicitor or adviser. Citizens Advice Newcastle have experienced advisers to help you with this.
What is an Advance Statement?
An advance statement is different from an advance decision, as it is a more general document detailing your views and beliefs. This could include issues around diet and personal care, such as bathing.
An advance statement is not a legal document but it can be used as a guideline for your care, should you become unable to communicate your wishes. It can also be used to nominate another person who you would like to be consulted about any decisions that need to be made.
Other Useful Information
- Advance decisions, advance statements and living wills – factsheet from Age UK.
- Advance Decision (living will) – End of Life care information by NHS.UK.
- LifeBook – Age UK free resource. It The LifeBook can help you to be more organised and could be invaluable to a family member or a friend if they need to locate important information about you in an emergency. Follow the step-by-step instructions and fill in the sections with your details, contacts and locations of important documents. Complete it online or order one.
- Campaign for Dignity in Dying believe everybody has the right to a good death – including the option of assisted dying for terminally ill, mentally competent adults. They are a national campaign and membership organisation campaigning for change across the UK. In the UK, It is illegal to help someone die. Their website has information about Advanced Wills.
- Gentle Dusk is an organisation that aims to raise awareness of the importance of end of life care planning through their training programmes and their futurematters volunteer-led project.
Last updated: April 1, 2021