‘Advanced decisions’ – frequently asked questions
Posted on 12th January 2023
Research shows that rates of dementia are rising in the UK.
More than half of UK adults know someone who has been diagnosed with dementia and it’s estimated that one in three people born in the UK in 2022 will develop dementia in their lifetime.
One way for the people affected and their loved ones to retain control over decisions about medical treatment and healthcare is to make an ‘advanced decision’.
What is an advanced decision?
Anyone over 18 who has capacity can create a document that explains how they want health care decisions to be made. This advanced decision will usually include issues that might need to be dealt with in the future. This could be, for example, refusal of life-sustaining treatment.
If an advanced decision states that you don’t want treatment that could save your life it must be a written document that you sign and which is witnessed by an independent third party. It must acknowledge that the document covers situations where you could die if medical treatment isn’t given.
Once made, an advanced decision is legally binding and will be considered by your medical team even when you no longer have capacity to make decisions for yourself.
Why would I write an advanced decision?
You might want to make an advanced decision because you feel strongly about certain things. You might want a written record which clearly states you don’t want certain types of surgery, resuscitation in certain circumstances, or if you develop an incurable illness. Alternatively, you might want to specify what should happen if you are involved in an accident which leads to life changing injuries, for example.
Is an advanced decision binding on medical staff?
An advanced decision will be binding for medical professionals. However, it might not cover all situations. If this is the case, emergency treatment might be given if it is in your best interests and this probably would not be regarded as unlawful. This is why it’s important, when writing an advanced decision, to include as many possible situations as you can.
Can an advanced decision be disregarded?
You might be given treatment if your advanced decision doesn’t cover a specific situation or if the medical team think you didn’t have mental capacity to make the decisions it includes. If possible, you will normally be consulted before a decision is made.
If you have already written an advanced decision and then set up a Lasting Power of Attorney (LPA) for your health and welfare, you might hand over responsibility for decisions about your treatment to your attorney. Their decision might conflict with your advanced decision because circumstances have changed, for example.
Can advanced decisions be updated?
You can update an advanced decision at any time. The new version should also be in writing, signed, and witnessed. If you do this you should destroy the previous document and tell your family and anyone involved with your care to avoid confusion about your wishes.
What is an advanced statement?
An advanced statement isn’t legally binding, although it should still be considered and referred to when decisions are made about your care. Its purpose is to make sure your wishes and feelings will be taken in to account, although you are happy for medical professionals to make decisions about your care in your best interests.
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