Living wills and advanced decisions
When we think about wills, it’s often in the context of future decisions when we’re no longer around. But as we’ll explore, living wills are about how we’d like to be cared for while we’re alive.
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A living will notifies healthcare professionals of your refusal to receive certain treatments in the event you’re unable to communicate your wishes or make decisions yourself. It can take the form of a written document that you share with loved ones and healthcare staff, or you can express your wishes to your doctor.
Yes, living wills are sometimes known as an advance decision. You may also encounter the term ‘advance statement’, which refers to the written document in which you express your wishes regarding your future care.
Attitudes towards ‘life and death’ health decisions are deeply personal to each individual, but here are some reasons why you might consider making an advance decision.
- You’ve been diagnosed with a serious illness, which has prompted you to draft a living will.
- You want greater control over key medical decisions and how you’d like to be cared for.
- You want clarity about your preferences and to reduce arguments among loved ones.
- You have a high-risk job and want to have a plan in place for a worst case scenario.
- You choose to reject life-sustaining medical interventions on spiritual or religious grounds.
A living will or advance decision is legally binding in England, Wales and Northern Ireland so long as the correct process has been followed. While living wills are not legally binding in Scotland, a doctor will often follow the instructions in the advance statement.
How to make a valid living will
For a living will to be considered valid, the following should apply:
- The living will document is signed by you, and if you wish to refuse life-sustaining treatment, a witness as well.
- You have clearly stated which treatments you would reject, why you would refuse them, and in what circumstances.
- You have the capacity to make the decision yourself.
- You have not made any statements or performed any actions that would contradict your living will wishes.
- Your living will must comply with the Mental Capacity Act, which is intended to protect those who lack mental capacity with regards to their health decisions.
If you’re in a critical condition, life-sustaining treatments are designed to keep you alive by replacing bodily functions with medical interventions. This includes being on a ventilator to assist your breathing, as well as antibiotics and CPR.
Your living will can include an advance statement which details your preferences regarding future care decisions. Here are some examples of what you could include.
- Your name, address and date of birth.
- Your NHS number.
- Your values or philosophy that inform your advance decision.
- The treatments that you would refuse, and in what circumstances.
- Details of any people you’ve appointed as a Lasting Power of Attorney.
- Details of any healthcare professionals you’ve discussed the decision with.
- Any distinguishing physical marks that could help identify you following an emergency.
You must be 18 years old or above in order to make a living will. If you wish to do so, it’s important that you get it done while you have ‘capacity’ in order for the advance decision to be valid.
You don't need to use a solicitor in order to make a living will. Some people choose to appoint a solicitor to help them draft their advance statement and provide specialist legal advice.
If you use a solicitor, it often takes between two and four weeks to create a living will. A solicitor might be able to complete it sooner if your needs are urgent.
You can expect to pay around £200-£250 if you use a solicitor to create a living will. But in theory, you can do it yourself for free