Advance Decisions and Advance Statements

Advance Decisions and Advance Statements allow service users to make important decisions about their future care and treatment.

To make either an Advance Decision or an Advance Statement a service user must have the mental capacity to do so. Advance Statements and Advance Decisions only come into force if the person subsequently loses capacity. Until that point they can make their own decisions on specific issues.

Advance Decisions are sometimes referred to as Advance Directives or Living Wills. These terms were used before the Mental Capacity Act 2005.

Advance Statements
A person must be at least 16 years old and have capacity to make an Advance Statement.

An Advance Statement is an expression of a person’s wishes or preferences, made when they have the capacity to do so, detailing what they would like to happen should they become unwell. An Advance Statement is not legally binding but expresses choice and preferences that should be respected and acted upon by staff (unless there are particular circumstances that prevent staff from doing so).

Advance Decisions
A person must be at least 18 years old and have capacity to make an Advance Decision.

An Advance Decision enables someone, aged 18 and over, while still having mental capacity, to document their wish to refuse specified medical treatment for a time in the future when they may lack the capacity to consent to or refuse that treatment. It is governed by the Mental Capacity Act and is a legally binding decision.

Advance Decisions and Advance Statements and The Mental Health Act 1983
Advance Decisions and Advance Statements may be overridden when a service user is detained under the Mental Health Act 1983 (MHA).

Making an Advance Decision and Advance Statement
It is recommended (although not compulsory) that you discuss the decision to make an Advance Decision with your GP, Care Co-ordinator or other appropriate health or social care professional.

You may wish to carry a contact card to indicate that you have an Advance Decision or Advance Statement in place.