Advance Decision

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An Advance Decision states preferences for healthcare treatment that reflect your personal values. This is one element of your key paperwork to have in place whatever age and stage you’re at.

If you ended up in a coma or vegetative state, would you want to be kept alive on a machine? If you have views about any treatment you wouldn’t want, get it down in paper or you might not be in a position to tell anyone.

In England this instruction is called an Advance Decision, in Scotland an Advance Directive or Advanced Healthcare Directive (AHD). In the past it’s been called an Advance Statement, a Personal Directive, a Health Directive, a Living Will. We call it an Advance Decision for short.  Whatever you call it, it’s a set of preferences about your values and treatment you would NOT want. The main difference between and Advance Decision and the old Living Will is that it has a legal standing*.

Download a free Advance Decision here. Share it with your GP to activate it. This is essential. It will then travel with your medical records electronically. Store a copy in your Final Fling Safe Deposit Box for safekeeping.

You might find some of the questions challenging and may need to think things over. You may want to discuss it with your doctor to be sure you understand the options.

Worth noting

  • *An Advance Decision is legally binding in England and Wales and underpinned by the Mental Capacity Act 2005. It’s common law in Scotland though in reality, a court would probably treat an instruction like this as legally bindingThe medical profession welcomes this approach because it offers clarity on difficult decisions and helps others understand your views and beliefs.
  • An Advance Decision lays out your preferences. It does NOT nominate someone to make decisions for you about your health care. If you want to do this, you must set up a Power of Attorney.
  • No-one can over-rule the decisions you’ve made in your Advance Decision (not even the person named in the Power or Attorney for Health and Welfare or other members of your family).
  • If you change your mind when you need treatment and doctors consider you ‘competent’ or able to make decisions, your decision at the time of treatment will overrule this Advance Decision.
  • Medical staff can be prosecuted for ignoring these instructions and wishes.
  • For more background on Advance Decisions, see the very helpful Compassion in Dying website.  If you need help or advice about Advance Decisions, contact Compassion in Dying on 020 7479 7731.
  • A DNACPR form must be kept separately on your medical records if you should NOT be resuscitated in the even of accident or collapse because the procedure would put you at risk.