The BBC drama series The Split has recently mentioned the use of an advance directive in the case of an individual with motor neurone disease.

An advance directive, also sometimes referred to as a living Will or an advance decision, sets out your wishes for the healthcare you would like in the future, in the event that you become unable to communicate them yourself.

What is an advance directive?

An advance directive is a written document setting out your decisions about your future treatment and healthcare. It is generally used by those who have an illness that may become worse or a degenerative health condition.

It can be helpful for your family to know what your wishes are, should you become incapable of communicating them in the future.

You can list any treatments that you wish to refuse and also set out the circumstances in which you want to refuse them.

What treatment can you refuse under an advance directive?

You can refuse life-sustaining treatment such as being put on a ventilator, antibiotics to fight infections and resuscitation. You can also choose to refuse food or drink by mouth.

You cannot ask to receive a specific treatment, nor can you elect to have your life ended. You are also not able to refuse basic care.

You should discuss your situation and the decisions you intend to make with your medical team and also with your family, who should ideally be aware of your wishes.

Your solicitor will be able to ensure that your wishes are clearly set out in an advance directive.

How to make an advance directive

Your advisor will be able to take all of the information needed from you. This will include:

  • Your name, address and date of birth
  • Details of your GP and your NHS number
  • Details of the circumstances in which you want to refuse different treatments
  • A list of each treatment that you wish to refuse
  • Confirmation that you wish to refuse the treatment even if it is life-sustaining
  • Confirmation that you made the decision yourself and of your own free will

You can also explain why you are making the decisions that you have made, for example, that you do not want to continue without quality of life or you want to avoid pain.

Once the advance directive has been drawn up, your solicitor can ensure that it is properly executed, to include being signed by one or two witnesses. A witness must not be a relative, your spouse or partner, anyone who benefits under the terms of your Will or someone whom you have appointed to act for you under a Lasting Power of Attorney.

Before signing an advance directive, you should check whether it will affect any life insurance policy you hold, if you intend to refuse life-sustaining treatment.

An advance decision can be cancelled by you at any time, provided you have the capacity to do so. You should advise everyone involved and have the document destroyed.

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