So, when you are ill, if you can get an appointment with your Doctor then, you can usually discuss treatment options with them and then jointly, reach a decision about your future care.
However, you may be admitted to hospital when unconscious or become unable on a temporary, or permanent basis, to make your own decisions about your treatment, or communicate your wishes. This may happen, for example if you have a car accident, a stroke, or develop dementia.
So, under this scenario you would ‘lack mental capacity’ to make an informed decision or be able to communicate your wishes. In such situations, doctors have a legal and ethical obligation to act in your best interests. However, one exception to this is if you have made an advance decision refusing treatment. If this decision is valid and applicable to the circumstances, medical professionals providing your care are bound to follow it.
What Is an Advance Statement?
This is a general statement of your wishes and views. It allows you to state your preferences and indicate what treatment or care you would like to receive should you in the future, be unable to decide or communicate your wishes for yourself. It can include non-medical things such as your food preferences, or whether you would prefer a bath to a shower.
Advance statements can also be used to let the people treating you know who you would like to be consulted, at a time a decision has to be made, if you are unable to make that decision yourself.
What Is an Advance Decision to Refuse Treatment?
An advance decision to refuse treatment is the only type of living will that is legally binding. An adult with mental capacity can refuse treatment for any reason, even if this might lead to their death.
However, no one is able to insist that a particular medical treatment is given, if it conflicts with what the medical professionals providing the treatment conclude is in the patient’s best interests. This is why an advance decision can only be a refusal of treatment.
An advance decision to refuse treatment must indicate exactly what type of treatment you wish to refuse and should give as much detail as necessary about the circumstances under which this refusal would apply. It is not necessary to use precise medical terms, as long as it is clear what treatment is to be refused and in what circumstances.
How to Make an Advance Decision/Living Will to Refuse Life-Sustaining Treatment?
- The decision must be in writing. You can ask someone else to write it down if you cannot do it yourself
- You must sign the document. You can instruct someone to sign it on your behalf in your presence if you cannot 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 your life is at risk
You should take steps to make sure that the people providing your treatment will be aware of your advance decision at the relevant time. This could mean discussing it with your GP, or other treating doctors, while you still have capacity to do so, and making sure that a copy of your decision is kept in your medical notes. It would also be helpful to make sure that your family and friends are aware of the decision. If the person providing your treatment is aware of your advance decision, they must then consider whether it is valid and applicable to the particular circumstances.
Why Make an Advance Decision?
You may wish to make an advance decision if you have strong feelings about a particular situation that could arise in the future. This might relate to having a limb amputated following an accident or having a blood transfusion.
More commonly, you may have been told that you have a terminal illness or form of dementia. You may wish to prepare an advance decision indicating the type of treatment you would not want to receive in the future. Making an advance decision may give you peace of mind in knowing that your wishes should not be ignored if you are unable to take part in the decision making process at the relevant time.
Considering making an advance decision provides an opportunity to talk to and ask questions of your medical team during the early stages of an illness rather than delaying it until it is more difficult to participate. It can also provide an opportunity to discuss what may be difficult issues with family and friends.
What happens if there are disagreements about an advance decision?
The senior healthcare professional treating you is responsible for making the decision as to whether there is a valid applicable advance decision. If there is a dispute over this, an application can be made to the Court of Protection.
If you are serious about an Advance Decision and you want it to work then it is advisable to have your Advance Decision drafted by a professional, call us on 01529 306005.
For further information or assistance, please contact us via:
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