If you are thinking of creating an Advanced Decision, please read this guide beforehand. We hope that it will answer some of your initial questions, but we also recommend that you contact us to discuss the process in more detail before proceeding.

Firstly, it is important to note that what used to be known as a Living Will, and later an Advanced Directive, is now known as an Advanced Decision (AD).

What does an Advanced Decision do?

An Advanced Decision is a legally binding document that sets out any medical treatments that you wish to avoid should you become ill in the future.  It is useful where a person becomes ill and would otherwise be given certain medical treatments, such as artificial ventilation, yet they lack the capacity (e.g. following a stroke), to communicate the fact that they do not wish to be given this treatment.

Before beginning to create your AD, you should consider:

• Which treatments you wish to avoid

• Who you wish to be involved in your future care

• Which illnesses or conditions you would like to include in your AD

• Why you are making the decision

• Who will be your witness when signing your AD

• Who you will discuss your AD with

Making an Advanced Decision

An AD must be valid and applicable before it can be used.  The criteria for validity are:

• You must be over 18.

• You must have capacity to create the AD.  What is capacity? 

• The AD must state clearly which treatments are being declined and in which scenarios.  (We can ensure that this criteria is met using our form).

• You must not have acted inconsistently with your AD since making it.

• You must not have stated in a Lasting Power of Attorney that your Attorney should make the treatment decisions that you have declined in your AD.

• Your AD must state that you decline life-sustaining treatment (if you wish to do so), in the knowledge that this may put your life in danger.

• Your AD must be signed and dated.  

• Your AD must also be signed by a witness

Once completed, you should let your loved ones know that you have created your AD. You could give a copy to those whom you wish to be involved in your future care. You should certainly give a copy to your GP surgery and ask them to make a note of it, or upload a copy to, your Summary Care Record. (Your Summary Care Record is your electronic medical record) Having this on your record means that it is easily accessible by healthcare professionals. If a healthcare professional is aware that you have an AD and does not follow it, they could go to court.

If you would like to purchase a piece of jewellery that has “Advanced Decision” engraved on it, please contact MedicAlert on 01908 951045.

Limits of an Advanced Decision

There are some things that an AD cannot be used for.  These include:

• Refusing basic care such as being kept clean.

• Appointing another person to make decisions for you.  To do this you should consider creating Lasting Powers of Attorney.

• An old Living Will may not meet the modern criteria for validity, so if you have one of these and you would like it to continue, it is a good idea to update this to and Advanced Decision, giving you peace of mind.

Lasting Powers of Attorney

Once you have created your AD, you may want to consider creating Lasting Powers of Attorney (LPA).  These are official documents which appoint other trusted people to make certain decisions for you if you are no longer able to manage your own affairs.  Please see our Frequently Asked Questions or read our guide to creating Lasting Powers of Attorney.

Reviewing your Advanced Decision

As with many important documents, its always a good idea to review your AD every couple of years.  For this reason, we have a useful form that we include for our AD customers that provides a review date, as well as a record of who you have given (or intent to give) copies of your AD to.

Amending an Advanced Decision

If you wish to amend your AD once it is created, the clearest thing to do is to create a new one.  Once created, you can destroy your old AD and advise the people who have a copy, including your GP surgery, to do the same.  You can then provide them with copies of your new AD.

Revoking your Advanced Decision

Once you have an AD, if you wish to revoke it, you can simply destroy it, and instruct the people who hold copies of it to destroy their copy.  You should also inform your GP Surgery that you have revoked your AD and request that they update your Summary Care Record.

We hope that this guide is useful, but it is likely that you may wish to find out more before proceeding with an AD.  Please contact us here to discuss your circumstances in more detail and we will arrange a convenient time to speak to you.