How to make an advance decision

Read our guidance on how to make and update an advance decision.

An advance decision can be as simple or as complex as you want it to be. It is up to you to decide how much detail you include.

You can draft an advance decision yourself using your own words.

Making your advance decision verbally

Unless you want your advance decision to cover life-sustaining treatment, you can make it verbally – that is, you can say what you want to happen. There is no set format for making a verbal advance decision as it depends a lot on the circumstances when it is made. There are a few things that you can do to ensure that it is still valid, however.

Your verbal advance decision should still be recorded in your medical records by a medical professional as this can help avoid confusion later. The record should include:

  • a clear note of the treatment(s) to be refused if you lack the capacity to make the decision at the time
  • details about the person who witnessed your decision
  • whether or not the health professional heard your decision themselves.

It is always better to make your advance decision in writing, if possible. This ensures that medical professionals are aware of your wishes and that they are correctly understood.

Other tips to making your advance decision

Talk to your GP

It is strongly recommended that you discuss an advance decision with your GP before drafting it. They will be able to explain how your condition is likely to affect you as it progresses, and what treatment you may need. They can help you understand the advantages and disadvantages of choosing or refusing treatment in advance.

A GP can also explain some of the problems that may arise from an unclear statement, and will be able to confirm that you had mental capacity at the time that you wrote your advance decision.

Consider talking to a solicitor

You don’t need to consult a solicitor to make an advance decision, but it can be a good idea. If you are uncertain about what you want to include or how to say it, a qualified solicitor can help make sure that your views are clearly expressed. However, be aware that a solicitor may not be able to advise you on how your condition might progress and the treatments and interventions that may be available. For this you should talk to your GP.

Important information to include

If you choose to draft your own advance decision, include the following information:

  • your full name
  • your address
  • your date of birth
  • any distinguishing features (eg tattoos, birthmarks)
  • the name, address and telephone number of your GP
  • the date you made the advance decision
  • your signature
  • the dated signature of at least one witness aged 18 or over. Ideally this should not be a partner, spouse, relative, anyone who stands to benefit under your will, or your attorney under a Lasting power of attorney. It’s a good idea to state their relationship to you
  • an explanation of the circumstances where you want your advance decision to apply – for example, it may say that you want to refuse the specified treatment only if you have a terminal illness
  • the specific treatment/s that you want to refuse, such as cardiopulmonary resuscitation (CPR) or artificial feeding and hydration – for more information on medical treatments that you could include, speak to your GP
  • a statement that says your advance decision was drawn up without pressure from other people
  • if the advance decision applies to refusing life-sustaining treatment, a very clear statement that the advance decision applies to the treatment in question, even if your life is at risk.

Make copies of your advance decision

You should make a copy of the document for yourself and keep it somewhere safe, You should also make several other copies and give them to the following people:

  • your GP, to keep with your medical records
  • your hospital team, to place in your case notes
  • a close relative or friend
  • your attorney under a Lasting power of attorney for health and welfare, if you have one.

Review your advance decision regularly

You should review your advance decision regularly to make sure that it still properly reflects your intentions. However you must have mental capacity to make any changes.

To do this, you can start afresh and complete a new form. Or you can make changes to your existing document, making sure you sign and date it again to confirm the changes.

Whether you amend the original form or complete a new one, you must make sure that an independent witness also signs and dates the new version. Be sure to give copies of the revised version to everyone who held a copy of the original version.

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