Make sure you have detailed instructions in place with this living will for when you are no longer able to make decisions for yourself. This advance decision covers circumstances in which you might not want to be kept alive artificially and allows you to set out specific instructions for medical treatment you would and would not like to receive. Use this living will only if you have discussed the matter with your GP and your family.
Overview of the Living will / Advance decision
When should I use a living will?
Use this living will:
- if you are of sound mind now and want set out directions for how you will be cared for in the future if you lose capacity and cannot make decisions for yourself
- if you feel very strongly that you do not wish to be kept alive artificially in a situation where you are extremely ill and also are no longer able to make decisions for yourself
- only if you have discussed the matter with your GP and your family and have no doubts about what treatment you wish to receive
What's included in a living will?
This advance decision covers:
- the circumstances in which you do not want life sustaining treatment if:
- you have lost the ability to make your own decisions (you have 'lost capacity'); and
- you are no longer able to care for yourself; and
- you have one or more carefully considered conditions such as a terminal or degenerative disease or permanent pain from which you are unlikely to recover
What's a living will?
A living will allows you to state your wishes regarding the way you are looked after in the event that you lose your mental capacity, including preferences for methods of medical treatment and refusal of certain types of treatment. A living will can refer both to an advance decision or an advance statement (which is a separate document).
Do I need a living will?
If you lose your ability to make decisions due to an illness (such as dementia) or an accident which results in a brain injury, you can maintain some control over your affairs with a living will. This often works in conjunction with a Lasting Power of Attorney (LPA). In the absence of any instructions regarding how you wish to be treated, you are more likely to receive care which does not fit with your beliefs (social or religious).
What is the difference between an Advance Decision and an Advance Statement?
An advance decision is a document in which you can specify any medical treatments which you wish to refuse, so that doctors and other medical staff are aware of your decision in case you lack the mental capacity to state your refusal at the time (eg. because you have advanced dementia, brain damage or are unconscious). An Advance Decision should clarify the circumstances under which you do not wish to receive specified treatments, as far as possible. It only allows you to refuse certain treatments; not request them. Note that it can be used to refuse treatment even if doing so might lead to your death but it cannot be used to ask for your life to be ended. Unlike an Advance Statement (see below), an Advance Decision is legally binding.
An advance statement is a separate document, this sets out how you wish you be cared for if you are unable to state your preferences due to a lack of mental capacity. It can include a range of matters including dietary requirements and whether you would prefer to be at home or in a medical facility. It may also state any religious beliefs you hold which could affect the treatment you receive. It should be noted that an Advance Statement is not legally binding but doctors and others caring for you must take it into account.
How can I make an Advance Decision legally binding?
If you wish to refuse life sustaining treatment as part of an Advance Decision, you must:
- Ensure that this is in writing;
- Sign and date the document - in the presence of a witness who must also sign the document;
- Be as clear as possible about the circumstances under which you do not wish to receive treatment; and
- Include a statement which clarifies that you would like the Advance Decision to apply even if this puts your life at risk as a result (this statement is covered by the section in this document entitled 'moral reasons for making this living will').
You can also (optionally) ask your GP to sign a statement confirming they are aware of your Advance Decision. Either way, make sure that your GP, any relevant medical staff and/or your relatives know you have an Advance Decision and where to find it.
Further advice
Ask a lawyer for:
- about a lasting power of attorney for health and welfare, in which you give someone else the power to make decisions for you
- if you already have a lasting power of attorney for health and welfare, as you may invalidate one or both if you then sign a living will/advance decision
- about any issues arising out of this document
This advance decision is governed by the law of England and Wales.