Chapter 28: End of life care
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Legal and professional issues
Advance directives
Advance directives, formerly known as ‘living wills’, allow people to make a legal decision to refuse, in advance, a proposed treatment, or the continuation of that treatment, if at the necessary time the person lacks the capacity to consent to it. Advance directives can only be made by those who are deemed to have the mental capacity to do so, and allow only for the refusal of treatments – they cannot enforce the provision of specified treatments in the same circumstances (Mental Capacity Act 2005, sections 24–26).
Decisions to refuse life‐sustaining treatments must be made in writing, be signed and witnessed, and must expressly state that the decision stands even if the person's life is at risk. Advance directives can be withdrawn verbally or in writing and are not considered valid if the person has conferred lasting power of attorney on another person. Furthermore, advance directives are invalidated if the person has done anything that is clearly inconsistent with the original advance decision made, for example, any change in religious faith.
The Mental Health Capacity Act 2005 (sections 24–26) forms the legal basis for advance directives.
