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This document can be used to inform doctors treating you that you wish to refuse certain life-prolonging treatments. The document and your wish to refuse treatment, will then be applied by doctors treating you if you are otherwise unable to communicate your wishes to them at any time.
This document can be modified to specify the circumstances when you wish to refuse certain treatments, and the nature of the treatments you wish to refuse.
How to use this document
It is recommended that you discuss the contents of this document with your GP. You should then sign the document and have it witnessed by at least one other person.
Once the document is signed you should provide a copy to your GP and, if you wish, to any other persons who may hold on to the document so that it can be produced if you fall ill.
You may then wish to periodically review the document, signing and dating it each time to confirm that you still wish to refuse the treatments specified.
Any Applicable Law
The Mental Capacity Act 2005 applies to advance decisions.
Help from a lawyer
You can choose to consult a lawyer if you need help.
The lawyer can answer your questions or help you through the process. You will be offered this option when you complete the document.
How to modify the template
You fill out a form. The document is created before your eyes as you respond to the questions.
At the end, you receive it in Word and PDF formats. You can modify it and reuse it.