Advance Decisions

Advance decisions and advance statements are just one aspect of planning ahead. You might also want to give someone ‘power of attorney’, so they can make decisions on your behalf, or to think about putting your finances in order and making or updating a will 

What is an advance decision? 

An advance decision allows you to decide now about specific treatments that you do not want to receive in the future. Its purpose is to ensure that, if you are not able to make decisions at the time, you are not forced to receive treatment that you would not want. 

Treatment that you can refuse includes life-sustaining treatment. For example, some people may make an advance decision to refuse a blood transfusion for religious or spiritual reasons. You can do this even if it will hasten your own death. 

Advance decisions are legally binding if they meet certain conditions. This means that they must be followed by doctors and other medical professionals 

For many people with dementia, there will come a time when you aren’t able to make decisions for yourself, such as choices about your care and treatment. This ability to make these decisions is known as ‘mental capacity’. There are a number of things you can do now to make sure your wishes are considered if you lack mental capacity in the future. These are often referred to collectively as ‘advance care planning’ or planning. 

Advance decisions and advance statements are two ways of planning ahead. They ensure that your wishes about your care and treatment are considered in the future. They can ensure that you are not given treatment that you do not wish to receive, or that your family have power to act on your behalf if you wish them to. This page explains how advance decisions and advance statements work, and what they can and cannot do. It also provides practical advice and a form to help you to draft an advance decision. 

What an advance decision cannot do 

An advance decision cannot be used to: 

  • refuse treatment if you still have the capacity to give or refuse consent 
  • refuse basic care that is essential to keep you comfortable, such as washing or bathing 
  • refuse food or drink by mouth (although it can be used to refuse feeding by tube) 
  • refuse the use of measures designed solely to maintain comfort – for example, painkillers (which relieve pain but do not treat the underlying condition) 
  • demand specific treatment 
  • refuse treatment for a mental disorder in the event that you are detained under the Mental Health Act 1983 
  • request something that is against the law, such as euthanasia or assisting you in taking your own life. 

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