We all have the right to decide what medical treatment we do (and don’t) want, so the idea of being in a situation where we have no say can be pretty scary. A living will, or advance decision, lets you refuse treatment in advance. The question is, do you want a living will? Or is there an alternative? Here’s what I think.
What’s a living will?
A living will is now officially known as an advance decision. It lets you set out any medical treatment you want to refuse and the circumstances when you want that to happen. It could talk about circumstances when you wouldn’t want to be resuscitated or whether there are specific treatments that you don’t want to have. It’s a document that’s signed and witnessed so it’s legally binding. It can only be used if you can’t speak for yourself to make your wishes known.
If you’re considering creating an advance decision it’s important to think about why you’re making that decision and what you want to achieve.
The problem with a living will
Advance decisions have their limitations as you can only refuse treatment. For example, you might want to refuse one type of treatment but be open to an alternative. An advance statement won’t let you say that. There isn’t any room for manoeuvre.
It’s also worth remembering that medical treatments can change over time. An illness that might once have meant a complete loss of your quality of life when you made your living will could have a better prognosis now. The side effects that come with some treatments may be managed much more easily as medical science progresses.
Living wills vs lasting power of attorney
A health and welfare lasting power of attorney (LPA) can give your attorneys permission to consent to life-saving treatment when you can’t. Otherwise, your doctors or social care team will decide for you. Your attorneys can also override their advice if it’s not what you would choose for yourself.
If you have an LPA it can come into conflict with an advance decision. The one that was made most recently carries the most weight and will be the one that your doctors follow. It could mean that your attorneys can’t act in the way you would want because their hands are tied by the advance decision.
My approach
If a client talks to me about an advance decision it is really important to understand who they want to make the final decision. If it is your attorneys, then a health and welfare LPA along with a letter of wishes will be more appropriate. The letter of wishes can include all the things that you would have put in an advance decision but in a way that gives your attorneys more flexibility to make the right decision. A letter of wishes can include a wider range of information that can help with other care decisions too.
I encourage my clients to have conversations about the things that are important to them and what they would choose for themselves. You can talk about your quality of life and the things that would affect that. It means that your attorneys decide based on the things you’ve talked about and the information they have from your doctors, rather than a statement that simply rules out certain forms of treatment.
Do you need help and guidance to create an LPA and letter of wishes? Get in touch using the form below or call us on 0116 380 0752.