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Advance Decisions to refuse treatment

Advance decisions are also known as living wills or advanced directives. The rules about Advanced Decisions are set out in the Mental Capacity Act 2005 and they enable you to provide advance instructions that result in a specified treatment not being delivered or continued, so that your instructions can be carried out even when you have lost mental capacity.

A health and care Lasting Power of Attorney usually gives the nominated attorney(s) powers that are broader than instructions covered in an Advance Decision, including decisions about the care you receive, your welfare and where you should live. When you make a Lasting Power of Attorney you can also specify whether your attorney(s) or your doctors make decisions about life sustaining treatment which will usually cover a broader range of issues than an Advanced Decision.

If you make a health and care Lasting Power of Attorney AFTER the Advance Decision which gives your attorney authority to decide, the Lasting Power of Attorney takes precedence. However, if you want both documents, please contact us for legal advice so that we can ensure they achieve what you want them to do.

There are two main advantages:

  1. They can be set up quickly (see below), whereas a Lasting Power of Attorney can take up to two months to register with the Office of the Public Guardian. If someone has a condition that is declining quite quickly an Advance Decision will be more timely.
  2. You may not have a trusted friend or family member that you can appoint as your attorney.  An Advanced Decision ensures that you can set out your wishes and professionals can follow them with the reassurance that it is what you want.


  1. You must be over 18
  2. You must have mental capacity – capacity is presumed
  3. If the advance decision relates to life sustaining treatment then it needs to follow certain rules. If it relates to other treatment there is no set format.
  4. Advance decisions only take effect if you lose mental capacity to consent to the particular treatment
  5. Advance decisions cannot be used to specify preferred treatment or to request treatment or something illegal e.g. euthanasia


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