Advance Decisions


What is an Advance Decision?

An Advance Decision (also known as an Advance Decision to Refuse Treatment, an ADRT, or a Living Will) is a choice you can make now to refuse a specific type of treatment at some point later.

This tells your family, carers, and health professionals about your wishes to refuse treatments if you cannot speak to them about these decisions yourself.

The treatments you decide to refuse must all be named in your advanced decision.

You may or may not want treatment in certain situations. In your advance decision, you can specify which circumstances you wish to refuse treatment.

Who makes an advance decision?

You are the person who makes an advance decision, as long as you have the mental capacity to do so. You might want to speak to a clinician to support you in making your advance decision.

If you are to refuse life-sustaining treatment, your advance decision needs to be:

  • Written down
  • Signed by you
  • Signed by a witness

In circumstances where you could die from refusing life-sustaining treatment, you need to state this clearly in your advance decision. It may be useful to speak to a doctor about the kinds of treatment you may be offered in the future, and decide whether you would like to refuse or receive them.

How does an advance decision help?

An advance decision gives you health and social care workers clinical and legal instructions about your treatment choices. As long as it’s valid and applies to the situation you are in. An advanced decision will only be used if you become unable to make treatment decisions by yourself.

Is an advance decision legally binding?

An advance decision is legally binding as long as it:

  • Is valid
  • Applies to the situation
  • Complies with the Mental Capacity Act.

If your advance decision is binding, it supersedes decisions made in your best interest by other people.

An advance decision will only be considered valid if:

  • You’re over the age of 18 and had the capacity to make, understand, and communicate your decision when you made it
  • You specify clearly which treatments you wish to refuse
  • You explain the circumstances in which you wish to refuse them
  • It is signed by you, and by a witness if you want to refuse life-sustaining treatment
  • You have made the advance decision by yourself, and have not been pressured by someone else
  • You have not said or done anything that would contradict the advance decision since you made it (e.g. saying you’ve changed your mind)

Who should see your advanced decision?

You ultimately have the final say o who sees it, but you should ensure that your family, carers, or social care professionals know about the decision. You should also tell them where they can find it. Your family or carers may have to find it quickly in an emergency if you require treatment, and they need to tell healthcare professionals your wishes. You can keep a copy in your medical record.

Refusing CPR in advance

Everyone has the right to refuse CPR if they wish to do so. You can make it clear to your medical workers that you do not wish to receive CPR if your heart stops beating or you stop breathing.

This is known as a DNACPR decision or order (Do Not Attempt Cardiopulmonary Resuscitation)

Once a DNACPR decision has been made, it is then put into your medical records, usually on a form that health professionals will recognise.

It is important to inform your family and carers of your DNACPR decision, so it does not surprise them when, and if, the situation arises.

If you are undergoing surgery or have a serious medical condition that could cause respiratory or cardiac arrest, a member of your medical team should ask you about your wishes if not previously known. If you do not have the mental capacity to make a decision regarding CPR and you do not have an advanced decision in place, the healthcare team will consult your next of kin about what they know to make a decision in your best interests.


We’ve been helping people with their wills for over 15 years. Covering areas such as Runcorn, Liverpool, Warrington, Frodsham, and Chester. Get in touch today and see how we can help you. We have a specialist team of professionals who are happy to answer any questions you may have. You can find our details on the Contact Us page.

Our team are members of Society of Will Writers and are SWWEPP Qualified, and we offer one-to-one appointments either face-to-face or over the phone/zoom.