An Advance Decision (sometimes called a 'living will') is a legally binding document that lets you refuse specific medical treatments in advance, in case you later become unable to communicate your wishes.
This is different from a Health & Welfare LPA, which appoints someone to make decisions on your behalf. An Advance Decision sets out your own specific instructions — for example, refusing life-sustaining treatment in certain circumstances.
In 2026, Advance Decisions are governed by the Mental Capacity Act 2005. To be valid, you must be 18 or over, have mental capacity when you make it, and it must be made voluntarily without pressure from others.
If your Advance Decision relates to life-sustaining treatment, it must be in writing, signed and witnessed, and include a statement that it applies even if your life is at risk. Without these formalities, it won't be legally binding.
An Advance Decision only covers treatment refusals — it cannot be used to request specific treatments or to ask for assisted dying (which remains illegal in England and Wales in 2026).
It's important to review your Advance Decision regularly and to ensure it doesn't conflict with any Health & Welfare LPA you may have. If there's a conflict, the most recently made document typically takes priority.
At Castle Family Legal, we can help you create an Advance Decision as part of your overall estate plan. Contact us to discuss your wishes and ensure they're properly documented.
