Advanced medical decisions

An advanced medical decision, often referred to as an 'advance directive' or 'living will', is a written statement of your wishes about medical treatment if you become terminally ill or incapacitated. An advance medical decision allows a person to refuse specified treatment in specified circumstances such as: -

• Physical illness which is so serious that life is nearing an end and there is no likelihood of recovery;
• Permanent serious mental impairment with physical illness and/or
• Permanent unconsciousness.

You are completely free to refuse to undergo medical treatment even if, as a result it brings about your death. However, you must have the mental capacity to make that decision. The Mental Capacity Act 2005 gives clear legal status to advance medical decisions, which means that health professionals must follow them, if they are valid and applicable to the specified treatment and circumstances.

It is important that an advance medical decision is well drafted so it is valid and applicable to the specified treatment and circumstances. You should discuss your wishes with your immediate family. The document is not intended to be a substitute for discussion with medical staff and it is always recommended that you talk fully with your doctor about your treatment. An advance medical decision does not ask a doctor to do anything against existing law, but it is useful when decisions have to be made on prolonging an individual's life.

An advance medical decision will be valid if: -

• You have the mental capacity to make the decision to refuse treatment;
• Your refusal was intended to apply in the kind of situation which later arose;
• You understood fully the consequences of such decision in that kind of situation and,
• There was no undue influence made by anyone else on your decision.

If you change your mind at a later date, an advance medical decision is not final and irrevocable and can therefore be changed by telling your doctor. However, it is sensible to destroy the document and all copies of it.

For further information contact Jenny Pierce the Head of our Wills, Trusts and Mental Capacity Team in the first instance.