An Advance Decision is often called ‘a Living Will’ and is an important legal document.
An Advance Decision is different to a health and care decisions Lasting Power of Attorney which is a document by which you can appoint a health and welfare ‘proxy’, someone to step into your shoes and make decisions in your best interests, at a time when you lack mental capacity.
It is important to understand that neither you, nor your relatives can demand that you be given specific treatment, but now their views must be taken into account by health care professionals. There may be situations where you want someone to be able to refuse treatment on your behalf.
An Advance Decision is a decision that you make (once you are aged over 18 and provided you have mental capacity) so that if:-
- At a later time and in such circumstances as you specify, a specific treatment is proposed to be carried out or continued by a person treating you, and
- At the time you lack capacity to consent to the carrying out or continuation of the treatment, then
- The specified treatment must not be carried out or continued
An Advance Decision is an important ‘right to choose’ and not a ‘right to die’, or ‘a right to life’.
If for any reason your Advance Decision is not valid and applicable, it will still be evidence of your wishes now.
Some Important Benefits of Making an Advance Decision
An Advance Decision can safeguard your dignity and privacy at a time when you are incapacitated, against unwanted or unwarranted treatment.
They are important if you do not want to be kept alive through artificial procedures when you have no quality of life, and where these artificial procedures are not medically necessary, or beneficial to you.
An Advance Decision can lead to better communication between you and your GP, family and friends on treatment options at the end of your life and they enable you to plan for possible future incapacity.
These important documents can relieve your friends and family and your medical team from the responsibility of having to make a decision without knowing your wishes. They help and strengthen your family’s confidence in the difficult end of life decision making process.
Your Advance Decision Cannot be Ignored if it is Valid and Applicable
Health care professionals must follow your wishes if they are valid and apply to the particular circumstances otherwise they may face criminal prosecution or civil liability.
Your Advance Decision will not be considered valid if:-
- You have withdrawn the decision (and this need not be in writing) or;
- You have done something which is obviously inconsistent with the Advance Decision; or
- You have subsequently made a health and care decisions Lasting Power of Attorney giving your attorney the authority to give or refuse consent to the treatment which the Advance Decision relates to. You can make your health and care decisions Lasting Power of Attorney subject to an Advance Decision, or you can make the health and care decisions Power of Attorney before you make your Advance Decision.
Your Advance Decision will not relevant or applicable if you have the mental capacity to give or refuse consent to the treatment, or the treatment is not the treatment specified in your Advance Decision, or if the circumstances which you contemplated when you made the Advance Decision have not come to pass.
Your Advance Decision will not be applicable if there are reasonable grounds for believing that there have been changes in circumstances, which would have affected your decision, if you had known about them at the time you made the Advance Decision.
We will advise you of all the legal requirements to ensure that your Advance Decision is valid. It is important that your documents are professionally prepared as it is easy to inadvertently create documents that are contradictory and which defeat one another.
An Advance Decision to refuse treatment for a mental disorder can be overruled if you are detained in hospital under the Mental Health Act.
It can be reassuring to make an Advance Decision. They provide peace of mind and give a sense of greater control over treatment that you may eventually receive. This can reduce anxiety associated with the vulnerability of being helpless at the end of life, something that none of us like to think about.
We can discuss your wishes, advise on these important documents and answer your questions. We will make sure that there is no conflict between your Advance Decision and your health and care decisions Lasting Power of Attorney. We advise on the legal status of the different types of documents (there are different types of Advance Decisions that you may want to make) and can give you advice to make sure that the document is not overlooked in the future.
It is recommended that you talk to your GP or hospital consultant (if one is already involved in providing you with specialist care) about these important documents. They can advise you about specific conditions or situations that may be of particular concern to you. Legal advice is also very important.