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Advance Decision to Refuse Treatment Fill out the template

Advance Decision to Refuse Treatment

Last revision
Last revision 26/06/2023
Formats Word and PDF
Size 1 to 2 pages
Rating 4.8 - 7 votes
Fill out the template

About the template

Last revisionLast revision: 26/06/2023

FormatsAvailable formats: Word and PDF

SizeSize: 1 to 2 pages

Option: Help from a lawyer

Rating: 4.8 - 7 votes

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Advance Decision to Refuse Treatment

This document can be used to inform doctors treating a patient that lacks capacity that they wish to refuse certain life-prolonging treatments. In England and Wales and Northern Ireland, this document is known is an Advance Decision. In Scotland, this document is known as an Advance Directive. The document and the patient's wish to refuse treatment, will then be applied by doctors treating the patient where they are unable to communicate their wishes.

This document can be modified to specify the circumstances when the patient wishes to refuse certain treatments, and the nature of the treatments they wish to refuse.

How to use this document

It is recommended that the contents of this document be discussed with the patient's GP and existence of the document is recorded in the patient's medical notes. Once the document is completed, it should be signed by the patient and witnessed by at least one other person.

Once the document is signed and witnessed, a copy should be provided to the patient's GP to keep with their medical notes and can also be provided to any other persons so that it can be produced if/when the patient falls ill.

It is prudent to periodically review the document, signing and dating it each time to confirm that certain treatments still wish to be refused.

Applicable Law

The Mental Capacity Act 2005 applies to advance decisions in England and Wales.

The Adults with Incapacity (Scotland) Act 2000 applies to advance directives in Scotland.

Advance decisions in Northern Ireland are governed by common law.

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