Making choices when you have advanced cancer
You may need to make important choices in the later stages of your illness. However, there may come a time when you can’t make decisions or communicate easily.
Some people choose to write down their wishes in advance, or appoint someone to make decisions on their behalf, should a time come when they are no longer to able to do this themselves.
Advance statements/decisions to refuse treatment
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Normally you will discuss how you would like to be treated and which treatments you don’t want to have with your doctor or other healthcare professionals. Some people write down their choices in advance so that if they become unable to discuss things with their doctors or make decisions, the doctors will still know what their wishes are.
Instructions about the treatments you do or don’t want are called advance statements and advance decisions. They are sometimes known as living wills.
An advance statement is a general statement of your views and wishes. It can indicate the treatment you would prefer to have and can include non-medical things, such as your food likes and dislikes or religious beliefs. An advance statement is not legally binding, but your doctors should take it into account when deciding what’s best for you.
An advance decision to refuse treatment is simply a decision made in advance to refuse to have certain treatment. For example, you may decide that if your condition suddenly worsens and your breathing stops, you don’t want people to try to bring you round (resuscitate you).
Making an advance decision to refuse treatment means you need to say which treatment/s you do not wish to have and the circumstances in which you don’t want treatment. You can change your mind and rewrite your advance decision at any time. A copy of your advance decision to refuse treatment can be kept in your medical and nursing notes.
You may also find it helpful to read the leaflet Planning for your future care: a guide, which has been produced by the NHS National End of Life Care Programme. You can ask for a copy from your GP or at your local hospital information centre. The leaflet is also available on the Department of Health Care Network’s website.
It’s important to discuss your wishes with a medical professional such as your GP or consultant. Remember that your family and friends may see things very differently from you. If possible, it’s good to have an honest and open discussion with your partner, relatives or closest friends in advance, so that they know and understand your wishes.
A Power of Attorney gives someone you trust the right to make decisions about your financial, legal or health affairs if you become unable to do so. Some types of power of attorney allow the person to make decisions about your care and treatment. Other types allow the person to make decisions about your property or financial affairs.