An advance decision is sometimes known as an Advance Decision to Refuse Treatment, ADRT or a Living Will. 

It is a decision that an individual can make about specific types of treatment they wish to have or refuse at some time in the future.

Advance decisions ensure everyone involved in providing care and support to the individual know their wishes if they are unable to make or communicate those decisions at a time in the future when the decision needs to be made. 

An individual can make an advance decision, as long as they have the mental capacity to make such decisions.

Their wishes need to be clearly set out stating all the circumstances in which they want to refuse treatment. 

People can refuse to have a treatment that could potentially keep them alive (known as life-sustaining treatment).

This includes treatments such as ventilation and cardio pulmonary resuscitation (CPR), which may be used if they cannot breathe by themselves or if their heart stops.

Individuals should be encouraged to discuss making advance decisions with a doctor or specialist who knows about their medical history before they make and document this advance decision.  

If an individual decides they wish to refuse a treatment, it is not the same as asking someone to end their life or to help them to end their life. 

Intentionally ending a life, even if it is in order to relieve pain and suffering is called euthanasia or assisted suicide which is illegal.

If an individual decides to refuse life-sustaining treatment in the future, their advance decision needs to be:

Life-sustaining treatment

Life-sustaining treatment is treatment that replaces or supports ailing bodily functions.

For example, 

• a mechanical ventilator can help a person to breathe, 
• or taking antibiotics can help their body to fight infection.

If they wish to refuse life-sustaining treatments in circumstances where they might die as a result, they need to state this clearly in their advance decision.

Life-sustaining treatment is sometimes called life-saving treatment.

An advance decision is legally binding as long as it:

If an advance decision is legally binding, it takes the place of decisions made in the individual’s best interest by other people. An advance decision may only be considered valid if: