Advance Decision for Medical Treatment

Published / Last Updated on 23/10/2014

Video explains the choices you can make for medical treatment if you are not able to decide at the time that are legally binding via an 'advance decision' and the differences with an 'advance statement'.


“Hello there.  The subject for this video is the ‘advance decision’.  

What is an ‘advance decision’?  An advance decision is you giving written instructions or you giving guidance in terms of if you lose mental capacity you then give guidance to your doctors, to the hospital, to your family as to what sort of medical treatment you would like or indeed not.

For example: You are diagnosed with cancer but you've lost mental capacity and it's:

What treatment do I want or what treatment do I not want? 

Do I want life-support medication?  Do I not?

This is quite a difficult subject but it's very helpful to have made an ‘advance decision’ on medical treatment or care that you would like if you've lost mental capacity.

So, if I talk through the basic requirements here, first things first:

  1. You must have mental capacity today. So you a must have ‘all your marbles’ today to be able to make the advanced decision
  2. You must be an adult, you must be over the age of 18 to make the decision
  3. Guidance is, it has to be very specific, it cannot be ‘woolly’.  So any statements that you make are very specific and then finally
  4. We suggest it has to be in writing and then you have to have independent witnesses who can attest to your ‘advance decision’ to say that person was of sound mind and body when they made that decision.

So that's what an advance decision is. It is you formalising, in writing, what you would like or not like in terms of medical treatment etc Excuse me.

It is legally binding.

It is legally binding on your GP, on your doctors, on your health care workers etc.

It is legally binding, they have to follow your instructions you've given those instructions as to what medical care or treatment you would like.

What you can't do and certainly what all your carers cannot do is they cannot ‘not’ give you basic care. 

What I mean by basic care is making you more comfortable let's say with painkillers or feeding you by mouth, drink or food. 

If they wish to feed you through a tube you can actually refuse that in your ‘advance decision’ but the normal course of living, eating, drinking, bathing, to make you comfortable, all of those sort of things no problem they have to be delivered but if it's a specifically medical treatment that you do not want e.g. being fed through a tube, then you can refuse that.

But, what cannot happen in your ‘advance decision’ is you cannot break the law.  So you cannot instruct somebody to commit to euthanasia, to effectively kill you.  You cannot add instruct somebody to assist you in killing yourself.

So that’s what an ‘advance decision’ is. [A very] important document.  

Our suggestion is we can help you draft them, we can help you produce it and sign it and get it witnessed.  We would also suggest it's probably wise to talk it through with your family members and with your doctor, with your GP and it may even be advisable to ask your doctor to also witness your ‘advance decision’.

Separately, there is also an a less formal document called an ‘advance statement’.  An advance statement is not legally binding and I would say you can afford to be a little bit ‘looser’ with your general statement in terms of what would like to happen or not.

But ‘advance decision’ very specific:  

  • if I have cancer then I do not want this treatment
  • if I have X then I do not want Y

But ‘advance statement’ much, much looser to say these are my general wishes and your healthcare workers your GP etc. They’re free to make their own judgements on that.  So that’s more guidance but the advance decision is quite specific.

Like I’ve said:

  • you must have mental capacity to do it
  • be over the age of 18 and
  • it must be specific in terms of whatever the treatment is or whatever the conditions are and then
  • likewise you can't do anything that would break the law so you can't ask somebody to kill you and you can't ask somebody to help you end your own life.

Any questions, any help you need with advance decisions please do contact us.  Thanks very much for watching.”

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