A Living Will (also known as an Advance Decision) is a legal document which states your future wishes regarding medical care and can also include a list of specific treatments that you wish to refuse. This document will be used if you lose the mental capacity to make or communicate decisions about your medical care. While there is no set way to write an Advance Decision, we do have some advice on making one yourself in this step-by-step guide.
How to make an Advance Decision (Living Will)
A Living Will doesn’t have to be written by a legal professional, however, we highly recommend that you have your Advance Decision in writing, witnessed and signed, and kept safe, to make sure that your wishes can be followed.
If anything is unclear or contradictory a medical professional can decide that the Advance Decision is not valid and ignore your wishes. Therefore, to be on the safe side we advise you consult a solicitor to make sure there is no confusion.
Here are our 5 key steps to writing a Living Will.
Talk to your GP or healthcare professional
The first thing to do is to consult your GP or another healthcare professional. They will help you to understand the decisions you want to make and record them in a way that other medical professionals will understand. They will also be able to record that you had mental capacity when making it.
Writing your Advance Decision
Now you're ready to write your Advance Decision (Living Will) consult our Living Will Guide to see what medical treatments can and can't be refused.
Also, below is some useful guidance to help with the legal specifics of the document.
Get it witnessed, dated and signed
For Living Wills that include the refusal to resuscitate, it is legally required that they be witnessed and signed by someone else. You must also sign it.
Let your GP and others know and store it
Send a copy of the Living Will to your GP so that they can include it into your medical notes. You should also let friends and family know that you have made one and where it is stored so that they can let medical professionals know should it ever be needed.
Keep it up to date
Reviewing and updating your Advance Decision regularly will enable doctors to feel more confident in your decisions. Even if you don't make any changes its a good idea to date and resign it.
A Living Will does not allow you to delegate someone to make decisions for you should you lose mental capacity. For this you will need a Lasting Power of Attorney (LPOA)
We always advise people to set up a LPOA. If you decide to do this, we suggest you ask to include your health and wellbeing wishes. Your delegated attorney will only be able to override your Living Will if you state that they are allowed to in the LPOA.
What makes a Living Will valid and legal?
For a doctor to be assured that a Living Will is legal and valid it must fulfil a certain set of specifics:
- 1 You must be over 18 at the time of writing it
- 2 You must have the mental capacity to make your own decisions
- 4 It must state the conditions or circumstances where you want the Living Will to apply. For example if you have had a stroke or you have a terminal condition such as dementia and at what stage
What is legally required if refusing life sustaining treatment?
If you wish to refuse life-sustaining treatment there are some requirements you have to meet in order for it to be legally-binding. Some examples of life-sustaining treatments include needing artificial nutrition and hydration, breathing machines, or CPR. In addition to the requirements above, it must also fulfil the following requirements:
- 1 It must be in writing
- 2 It must state that the Advance Decision applies even if your life is at risk or shortened as a result of refusing treatment
What to include in your Living Will (Advance Decision)
There is no set or specific way that you have to write your Living Will as long as it fulfils the legal requirements above. However, we have supplied a list of items that we advise you to include:
- Full name, address and date of birth
- Clearly state it is your "Advance Decision"
- Your GP's name and address and whether they have copy
- Explain clearly and in full which treatments you are refusing under which circumstances
- State that it was made under full mental capacity
- State that the Advance Decision should only be used if you are without mental capacity
- If refusing CPR - state that it applies even if your life is at risk or shortened as a result of refusing treatment
- Your signature
- Your independent witness' signature
- The date on which you both signed (the same date)
Living Will rules for Scotland and Northern Ireland
In Scotland and Northern Ireland a Living Will is called an ‘Advance Directive’ and is not legally-binding. You can still make one using our guide and it can be considered when making medical decisions, but doctors are not legally required to follow it.
Before using a Living Will to make a medical decision your doctor must be sure that it is valid and that you no longer have mental capacity. They will also need to be sure that circumstances haven't changed since it was written e.g. new treatments available or that your circumstances have changed.
It is important to review and keep your Living Will up to date, so that your intentions are clear and there is no room for questions. If the doctor feels the information is not clear or there's an inconsitency, they can deem the Living Will invalid and ignore your wishes.