Advance decisions and Lasting power of attorney

As well as making an advance decision, you might have made or be thinking about making a Lasting power of attorney (LPA) for health and welfare. 

A Lasting power of attorney (LPA) is a legal document that you can use to appoint someone you trust to make decisions on your behalf, if you become unable to make them yourself. The person you appoint is known as an ‘attorney’.

There are two different types of LPA:

  • a property and affairs LPA
  • a health and welfare LPA.

There is a form to fill out for each. You can give your health and welfare attorney(s) the power to refuse life-sustaining treatment on your behalf by choosing a particular option on the LPA for health and welfare form. Your LPA will then need to be registered with the Office of the Public Guardian for it to be valid.

It’s important to think about how your advance decision and LPA for health and welfare work together if you have both. Whichever you make most recently may override the other.

What if I make an LPA first?

If you make an LPA first, the valid and applicable advance decision will stop your appointed attorney from agreeing to treatment (as it was made more recently).

What if I make an advance decision first?

If you make an advance decision first, the LPA will override your advance decision (as it was made more recently). This is only if it gives your attorney(s) the power to deal with the same decision about treatment. 

Should I mention my advance decision on my LPA form?

There is space to write about your advance decision on the LPA for health and welfare form. The guidance notes for the form say that if you have an advance decision that you want your attorney(s) to take into account, you should mention it when completing the form.

You must include a copy of the advance decision when you send your LPA to the Office of the Public Guardian to be registered. 

You might need to take legal advice if you are concerned about any confusion between the two documents.

Should I leave my decision to my LPA, or write it in my advance decision?

Attorneys have to act in your best interests when making any decision on your behalf.

For example, you could feel very strongly that you want to refuse certain treatments in certain circumstances. You may be certain that you do not want that decision to be challenged on the basis it is not in your best interests.

In that situation, making a valid and applicable advance decision would achieve this. In this case you should not give your attorney(s) power to refuse the same treatment.