Understanding Advance Decisions
An advance decision, also known as a living will, is a legal document that outlines your medical and healthcare preferences if you're unable to communicate these decisions in the future. This includes the refusal of specific treatments under certain conditions. To be eligible to create an advance decision, you must be 18 or over and have the current ability to make such decisions. While an advance decision can be made verbally, a written form is required, especially if it involves refusal of life-sustaining treatment.
Legal Obligations and Healthcare Professionals
Healthcare professionals are typically required to respect and follow advance decisions, as they are legally binding. This applies to informal patients, including those treated in hospitals. However, in emergencies where the scope of the advance decision isn't clear, professionals might administer treatment. The adherence to advance decisions has exceptions, including unclear refusals, revoked decisions, or if there's a lasting power of attorney in place.
Making an Advance Decision
To create an advance decision, you can choose a verbal or written format, though the latter is recommended for clarity and for instructions involving life-sustaining treatments. Documenting your advance decision helps in providing explicit instructions and eases future legal advice. If the decision isn't in writing, it's crucial to communicate clearly with healthcare professionals and family about your wishes.
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Refusing Life-Saving Treatments
You can specifically refuse life-saving treatments in your advance decision. To ensure it's legally valid, you'll need to write down your refusal, acknowledge the consequences of such decisions, and have it witnessed. However, note that you cannot refuse all types of healthcare or request illegal actions.
Restrictions on Refusing Treatment
Generally, you cannot refuse certain mental health treatments if you're detained under mental health laws. However, an exception is made for Electroconvulsive Therapy (ECT), which you can refuse through an advance decision. When making an advance decision while detained, ensure your decision-making capacity isn't compromised.
Altering Your Advance Decision
Your advance decision is not set in stone. You can update or revoke it anytime to reflect changes in your life or preferences. To avoid confusion, it's crucial to communicate any changes to involved parties clearly and consider remaking the document to reflect new decisions.
Resolving Disputes and Further Guidance
If there's confusion or disagreement about your advance decision, the Court of Protection can interpret its meaning. Additionally, alongside an advance decision, you might consider creating an advance statement, which outlines your preferences for care and living arrangements, though it's not legally binding like an advance decision.
These tools together help ensure that your healthcare and personal preferences are respected, even when you can't communicate them yourself.