Are you worried about losing your ability to express your wishes regarding your medical treatment? If you want to be clear about your wishes regarding your health and welfare, you should consider making an advance decision or a living will. Here is a look at what they are and how they work.
What is the primary purpose of a living will?
A living will allows you to state your wishes concerning specific medical treatments. The official legal name for a living will is an Advance Decision to Refuse Treatment, often called an advance decision in short.
The primary purpose of a living will is to allow you to outline any treatments you do not wish to receive in the future. The decision is used in situations where you are unable to communicate these wishes with the medical team. If the medical team can communicate with you regarding treatment, your decisions will always take precedent over the document.
A living will is only used when you are not able to state your wishes. It is also more about treatments you do not want to have, rather than about treatment and care you’d wish to receive.
A living will allows you to refuse life-sustaining treatment designed to keep you alive. These treatments include:
- Ventilation if you can’t breathe by yourself.
- Cardiopulmonary resuscitation (CPR) to restart your heart.
- Antibiotics to fight infection.
It is essential to understand that a living will and the refusal to receive a specific treatment could result in your death. Therefore, you must consider carefully whether you want to make it, and in which situations you would prefer to refuse treatment.
What can’t a living will do?
A living will only deals with medical treatments you want to refuse in particular situations.
The statement cannot include provision for the distribution of your estate on death. A living will doesn’t have any particular financial significance. If you worry about finances and things like Inheritance Taxes, then you need to look elsewhere. You can make financial decisions about your estate in your traditional will.
You also can’t nominate someone to make decisions on your behalf or request particular treatments. If you want to enforce decisions like this, then you need to make a Lasting Power of Attorney (LPA). These are designed to help you nominate another person to act on your behalf or be more specific about your care, including finances. There are two types of LPAs:
- An LPA for Property and Financial Affairs which covers decisions about your property and money.
- An LPA for Health and Welfare, which is about your health and personal welfare decisions.
You can nominate a different person for the two LPAs, and you do not have to make both if you do not wish to do so.
It’s crucial to note that LPAs could take precedence over the content of the living will if you do not mention your living will in your LPA.
It’s also important to remember that you cannot refuse food or water with a living will. Assisted suicide or euthanasia is not legal in the UK.
Is a living will legally binding?
Advance decisions are legally binding in England and Wales if they meet specific requirements. The living will must comply with the Mental Capacity Act and apply to the particular treatment and situation.
Advance decisions are only valid when:
- You are aged 18 or over, and you have the capacity to make, understand and communicate the decision.
- You clearly specify the treatments you are refusing.
- You outline the exact circumstances under which you wish to refuse those treatments.
- You sign the document along with a witness.
- You’ve not contradicted the advance decision, and you haven’t been forced or harassed into making it.
If your living will is valid and your healthcare professional knows about it, then they have to follow it.
A living will is called an ‘advance directive’ in Scotland and Northern Ireland where it isn’t legally binding.
How do you make a living will?
You need to think about what you want and the specific treatments you’d like to refuse. It is essential to be detailed and precise because any interpretation in the living will could mean that it won’t be enforced.
There is no set form for advance decisions, but you can find templates on websites like Compassion in Dying. It is crucial you sign and date your living will in the presence of a witness. The witness must also sign and date the form.
While you do not need your GP’s permission to make an advance decision, you could ask them to sign it as well. Having your GP signing the document can help ensure it covers the requirement of you being mentally capable of making a living will.
You should then give a copy of the living will to people close to you, your GP and anyone else involved in your care. You can also ask your GP to place a copy of your living will in your medical records.
Review and update your living will regularly
You should regularly review and update your living will. There is no timeline for how far back an advance decision applies. But if you made it a long time ago, it might raise doubts as to whether it continues to reflect your wishes. These doubts could cause a healthcare professional to disregard it.
It is especially useful to review your living will if you:
- Have been diagnosed with an illness.
- Have had a change in your health.
- Have a medical condition, and there have been advances in treating it.
- Haven’t reviewed your living will for over two years.
- Have changed doctors or moved.
- Have made a Lasting Power of Attorney for Health and Welfare.
You can cancel your living will any time you have the mental capacity to do so. Since the document could have a significant impact on your care, carefully consider the treatments you include. Consider talking about your wishes with your GP as well as your friends and family, too.