An Advance Decision to Refuse Treatment or Advance Directive is sometimes known as an Advance Decision, or Living Will. It’s a decision about specific treatments you don’t want to have. 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 to try to prolong your life.
If you refuse a particular treatment you will still receive good care and have medicines to help manage any symptoms you may have.
An Advance Decision to Refuse Treatment can only be made by someone aged 18 or over (16 in Scotland) who is able to understand the decision they are making. This is called having mental capacity. It must state exactly what treatment you want to refuse and may also state when the refusal should apply. It is helpful to include as much detail as possible.
An Advance Decision to Refuse Treatment or Advance Directive can’t include a request to be given specific treatments or to have your life ended.
Before making an Advance Decision to Refuse Treatment, it’s important to discuss the decisions you’d like to make with one of your healthcare professionals. It’s also important to share your decision with your family so they understand your wishes.
Once you’ve made your Advance Decision to Refuse Treatment, it’s best to write it down so that it can be kept in your medical and nursing notes. It’s helpful to give a copy to your GP. You may also be asked for permission 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.
There are certain situations where the law says an Advance Decision to Refuse Treatment must be in writing, for example, if it refuses treatment to keep you alive.