To ensure your advance decision is followed, you must tell people that you have made one. It's a good idea to write it down and give a copy to your loved ones and all those involved in your care. Your GP and medical team must know about your advance decision so that they can include it in your medical notes. You can change it at any time, but make sure that you clearly communicate, record and date these changes.
There are no official forms for writing an advance decision, although some organisations have produced various templates. The following guidelines could be helpful:
- Put the decision in writing.
- Include your name, date of birth, address and details of your GP.
- Specify what kind of treatment is to be refused and in what circumstances, giving as much detail as possible.
- Sign and date the document.
- Ask someone to witness your signature.
- You could ask your doctor or another relevant professional to sign a statement on the document saying that they have carried out an assessment of you and, in their opinion, you have the mental capacity to make the decision.
Advance decision to refuse life-sustaining treatment
If you want to refuse potentially life-sustaining treatment, there are legal requirements you must follow.
- The decision must be in writing. You can ask someone else to write it down if you can’t do it yourself.
- You must sign and date the document. You can ask someone to sign it on your behalf in your presence if you can’t sign it yourself.
- Your signature, or the signature of the person signing on your behalf, must be witnessed. The witness must also sign the document in your presence.
- You must include a written statement that the advance decision is to apply to the specific treatment ‘even if life is at risk as a result’.
The person who is a witness is signing only to show that they have witnessed the document being signed by you (or by the person signing on your behalf). They are not signing to confirm that you have mental capacity or that they affirm the advance decision.
Advance decisions and Lasting Powers of Attorney
It's possible to have both an advance decision and a Lasting Power of Attorney (LPA) for health and care decisions, but these are both legal documents and you need to think carefully about the order you make them in.
- If you make an advance decision after making an LPA for health and care decisions, your advance decision will take priority. This means that your attorney will not be able to override your advance decision.
- If you make an LPA for health and care decisions after making an advance decision, your attorney may be able to override your advance decision, but only if your LPA expressly gives your attorney authority to make decisions about the same treatment.
If in doubt, it's best to seek legal advice about the way these two documents will interact.