Normally, you’ll be able to discuss with your doctor or other healthcare professionals how you’d like to be treated and which treatments you don’t want to have. Some people write down their choices in advance. If they become unable to discuss things with their doctors or to make any decisions, the doctors and their family will know what their wishes are.
An Advance Statement is a general statement of your views and wishes. It can indicate the treatment you would prefer and how and where you would like to be cared for.
An Advance Statement isn’t legally binding, but your doctors should take it into account when deciding what’s best for you.
It can be very helpful if you write down your preferences and wishes. If you do this,
the key people involved in your care will know how you wish to be cared for. If you find
it difficult to know what to say, or how to say it, your doctor or specialist nurse will be happy to help you write a document or a letter that includes your wishes.
One example of a document where you can write down your wishes and preferences is a Preferred Priorities for Care document. You can download a copy of the National End of Life Care Preferred Priorities for Care document. This document may not be used in all parts of the UK, so check with your healthcare professionals if they have a specific document they recommend.
Advance Decisions to Refuse treatment
An Advance Decision to Refuse Treatment (Advance Decision, Advance Directive or Living Will) is simply a decision to refuse 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 back to life (resuscitate you).
Or, that if you’re very ill and have an infection, you don’t want to be given antibiotics.
An Advance Decision can only be made by someone aged 18 or over (16 in Scotland) who is able to make the decision (this is called having mental capacity). It must indicate exactly what treatment you want to refuse and in which situation. Demands to be given treatments or interventions can’t be included in an Advance Decision to Refuse Treatment.
In England and Wales, an Advance Decision to Refuse Treatment is legally binding. This means it must be followed by your healthcare team, provided they know about it. It must also meet certain criteria set out in the Mental Capacity Act (2005). Your healthcare team will be able to tell you more about this. In Northern Ireland and Scotland, an Advance Decision is legally binding, although it’s governed by common law instead of an Act and similar criteria apply.
Before making an Advance Decision, it’s important to discuss the decisions you’d like to make with one of your healthcare professionals. They can tell you the likely effects of any decisions you make. Remember that it’s important to share your decisions with your family so that they understand your wishes. Once you’ve made your Advance Decision, it’s best to document it so that it can be kept in your medical and nursing notes. There are certain situations where the law says an Advance Decision must be in writing, for example if it refuses treatment to keep you alive.
It’s helpful to give a copy of your Advance Decision to your GP. You may also be advised to give copies to the ambulance service, out-of-hours doctor, and district nursing and palliative care services. This makes sure that your wishes and preferences are known to the teams that you may need to contact, day or night.
You can change your mind and rewrite your Advance Decision at any time, but this should be clearly recorded.
We have more detailed information about an Advance Decision to Refuse Treatment.
You can also find more information on the Advance Decision to Refuse Treatment NHS website.