Advance Decision (to refuse treatment)

An advance decision is different from an advance statement of wishes and preferences in that it relates to the refusal of specific medical procedures or treatments. Under the terms of the Mental Capacity Act 2005 (Mental Capacity Act 2005), an advance decision can only be made when you have the mental capacity to make that decision and it comes into force only when you lose capacity and strict formalities have been complied with to make it legally binding.

These formalities are:

• that the decision must specify the treatment or procedure e.g. blood transfusion, assisted ventilation in certain circumstances
• the decision must be in writing, signed and witnessed
• there must be an express statement that the decision stands even if life is at risk