In England, both living wills and advance statements allow individuals to express their wishes about future medical care in case they lose the ability to communicate or make decisions. However, these documents serve different purposes and have different legal standings.
Losing someone special makes others reflect on themselves and how much they must prepare. A living will could give you and your family peace of mind and understanding of your wishes.
Key takeaways
- A living will and advance statement are different, but both inform your nominated carers what your wishes are.
- A living will is legally binding which specifies your medical care and life support desires if you become unable to communicate them.
- An advance statement is an important way for someone to share their preferences, beliefs, and values regarding future care, although it is not legally binding.
Table of contents
What is a living will?
A living will is a legally binding document which specifies your medical care and life support desires if you become unable to tell them. This is officially referred to in legal terms as an Advance Decision to Refuse Treatment (ADRT). This document specifies your medical care and life support desires if you become unable to tell them. The document can alleviate stress from family in a difficult time. By preparing a living will, you can give your dear ones your desires concerning your health care. Thinking ahead can avoid confusion/conflict in a time of crisis.
Key Features
- Legally binding: If valid and applicable, it must be followed by healthcare professionals.
- Covers refusals only: It only allows a person to refuse specific types of medical treatment in advance.
- Applies when you lack capacity: It only comes into effect if you lose the mental capacity to make or communicate decisions.
- Can refuse life-sustaining treatment: It can include a refusal of life-sustaining treatments like resuscitation, ventilation, or artificial nutrition – but this must be explicitly stated.
- Must be in writing and signed: Especially if it includes refusal of life-sustaining treatment, it must be:
- In writing
- Signed by the individual
- Witnessed
- Clearly state that the refusal applies even if life is at risk
What it might include
Refusal of treatments such as:
- Cardiopulmonary resuscitation (CPR)
- Chemotherapy or radiotherapy
- Blood transfusions
- Surgery or dialysis
Conditions under which the refusal applies (for example, if the person is in a coma with no chance of recovery)
Important notes
- A living will cannot request specific treatments – only refusal is allowed.
- It takes precedence over other forms of planning like an advance statement.
- If there is doubt about its validity or applicability, doctors may seek legal guidance.
How do I make a living will?
You do not have to use a solicitor when creating a living will, you can write one yourself. However, the benefit of using a solicitor would be that your wishes are clearly stated and the will complies with legal requirements.
You can create your own free living will.
Alternatively if you prefer to use a solicitor you could visit one of the links below to locate a solicitor near you.
What is an advance statement?
An advance statement is an important way for someone to share their preferences, beliefs, and values regarding future care, although it is not legally binding.
Key Features
- Not legally binding: Healthcare professionals must consider it, but they are not legally required to follow it.
- NHS friendly: Especially for people with long-term conditions or declining health.
- Covers personal preferences: It can include a wide range of non-medical and medical preferences.
- Flexible format: It doesn’t need to follow a legal format, as long as your wishes are clear for others to ensure they are followed.
- Applies when you lack capacity: It is considered only if you are unable to make or communicate decisions at the time.
What It might include
- Preferences for where you’d like to be cared for (e.g., at home or in a hospice)
- Daily routines (e.g., diet, hygiene, religious practices)
- Beliefs and values that affect treatment decisions
- Who should be consulted about your care
- How you like to be communicated with (e.g., spoken language, tone, etc.)
Important
- It complements other planning tools like a living will or lasting power of attorney.
- It gives healthcare professionals insight into what the person would have wanted.
- Although not enforceable, ignoring it without good reason can be challenged by family or carers.
How do I make an advance statement?
You can make an advance statement by writing down your wishes and preferences for future care, including details about how you want your care to be delivered. You should include who you would like to be involved, and what’s important to you.
A living will and advance statement differences
| Feature | Living Will (Advance Decision) | Advance Statement |
|---|---|---|
| Legal status | Legally binding | Not legally binding |
| Purpose | To refuse specific medical treatments | To express general care preferences |
| Includes life-sustaining treatment? | Yes (if stated clearly) | No (can express a wish but cannot refuse) |
| Must be in writing? | Yes, if refusing life-sustaining treatment | No, but writing is recommended |
| Can request specific treatment? | No | Yes, as a preference |
| Must be followed by professionals? | Yes, if valid | No, but should be considered |
Overview of differences
- Use a living will if you want to refuse specific future treatments, especially if they are life-sustaining.
- Use an advance statement to communicate your general preferences about how you want to be cared for.
Most people benefit from having both documents, especially when planning for end-of-life care. They ensure that your values, wishes, and beliefs are known, respected, and as far as legally possible acted upon.
What is a power of attorney?
Power of attorney is very important as it enables a nominated person to carry out either health and welfare and or property and financial responsibilities should you lose the capacity to deal with them.
There are two types of Lasting Power of Attorney (LPA).
Health and Welfare LPA
A health and welfare LPA allows the chosen person named as the attorney to undertake decisions about your medical care, daily routine, and living arrangements. This is only applicable if you were to lose the ability to make those decisions yourself. Is type of LPA normally helps a person caring for a person with memory loss, dementia or alzheimers disease.
Property and Financial Affairs LPA
A property and financial affairs LPA allows the chosen person to manage your finances and property, such as paying bills, managing investments, or selling property, and can be used while you still have capacity, with your permission.
This type of LPA can be used as soon as the attorney is registered unlike the health and welfare LPA which can only be used when you lose mental and or physical capacity.
Many people do not often realise that to have control over a person’s affairs, that you would normally need both types of LPA. For instance if an attorney were only to have a health and welfare LPA, and you were to develop dementia the attorney would then need a property and financial affairs LPA to deal with your finances. It is then harder to obtain this LPA when you are suffering from dementia and unable to make a sound decision.
Details of how to register a person as LPA are available by visiting the link
Conclusion
It is very advisable to have both an advance statement and living will, as they are both very useful for both your future well being, and likewise providing important information to others such as doctors and nurses. Whilst it is often advisable to get legal help to write a living will to ensure the wording is legally correct the advance statement does not require this formality.
Power of attorney is also very advisable to arrange as situations in life can and often do change very quickly. Nominating someone for power of attorney can provide peace of mind for both health and welfare as well as property and financial affairs should you lose the ability to make and carry out decisions.
