What is an advance decision? (Living wills explained)

Couple looking over paperwork.

What is an advance decision?

An advance decision is a legal document that sets out your wishes to do with future medical treatment. It lets others know when you want to refuse this treatment. It used to be called a living will.

Why would I make an advance decision?

The reason for making an advance decision is in case you can’t make decisions about your medical treatment in future. This might be because you become terminally ill or because you lose the ability, or what’s sometimes called ‘capacity,’ to do so for yourself. It also applies if you can’t communicate your decisions anymore.

For example, you could decide to refuse treatment at a certain stage of illness, or you could tell others about the type of care you want to receive.

Is an advance decision legally binding?

Yes, an advance decision is legally binding. This means that the people caring for you have to follow your instructions about your treatment. It will only be used if you lose the ability to make or share your decisions about your treatment.

An advance decision allows you to refuse treatment, even if it might lead to your death.

Do I have to share an advance decision with my doctor?

Yes. If you make an advance decision, your doctor (GP) and anyone else involved in your medical care needs to know about it. This is so they can include it in your medical notes. You might also want to talk to them about it before making your advance decision final.

Should I share an advance decision with my family and friends?

It’s a good idea to share an advance decision with your family and friends. This is so they can support you and talk with you about it if you’d like to. It can also help them to understand your wishes so they aren’t surprised by them at a later date.

Can I change an advance decision?

Yes, you can. You can do this at any point while you have the capacity to do so.

Does an advance decision have to be in writing?

The law says that an advance decision doesn’t have to be in writing, unless you’re refusing treatment to keep you alive. However, it’s good to put it in writing anyway to help your loved ones understand what you want to happen if needed.

What if I’m refusing treatment to keep me alive?

If you’re refusing treatment to keep you alive, you must put your decision in writing. It also has to be signed and witnessed by someone else. The words ‘even if life is at risk as a result’ have to be written in the decision too.

What exactly is treatment to keep me alive?

This includes:

How do I write an advance decision?

You can write an advance decision yourself if you’d like to. You don’t have to involve a solicitor, but it might be helpful.

Suggested guidelines for what an advance decision should contain are:

The main reason to make an advance decision is for your own peace of mind. It gives you control over what will happen if you lose capacity to make decisions about your future medical care, or if you can’t communicate your decisions. If you put the advance decision in writing, which is recommended, then it also means that others can be clear about your wishes too.

What is an advance statement?

You might also have heard of an advance statement. An advance statement is different to an advance decision. It’s a way of recording your preferences about your care if you lose the ability to make your own decisions in future.

What information can go in an advance statement?

Anything that’s important to you can go into an advance statement. This could include things like:

Is an advance statement legally binding?

No. It’s not legally binding, but the people making decisions about your care must take it into account. This means they should go along with your preferences where possible.

Is there a specific form for an advance statement?

No, there’s not a specific form for an advance statement, but it’s still a good idea to put it in writing. Using a template can be helpful if you decide to write it down. You can find these online and a good example is this NHS advance statement sample form. You don’t have to have the form witnessed.

If you don’t use a template and decide to write your own advance statement, make sure you include your full name, address and date of birth.

Learn more about planning your final wishes

An advance decision makes sure your wishes about medical treatment are followed. Here are some other things you might want to think about planning to make sure your family know what you want:


Photo licensed from iStock