Creating an Advance Directive is a key step to ensuring your healthcare wishes are followed precisely, no matter where you are and what would happen to you. But what exactly is an Advance Directive, and what does it involve?

Let's find out together what an Advance Healthcare Directive is, why it's crucial for managing your healthcare decisions, and how to create one that legally holds up.

We’ll also clear up a couple common myths about Advance Directives, helping you understand them better before you get started.

Advance Directive in Practice

An Advance Directive is a legal document that specifies your healthcare preferences in situations where you are unable to communicate your decisions.

It typically comes into effect if you are incapacitated or seriously ill. Through an Advance Directive, you can ensure that your medical treatment aligns with your wishes, even when you can't communicate them directly.

Living Wills vs Advance Directives

While the terms "Living Will" and "Advance Directive" are often used interchangeably, they actually have different meanings in the UK context.

Living Will is a specific type of Advance Directive that outlines your preferences for life-sustaining treatment if you are facing a terminal illness or irreversible condition and can no longer express your wishes. It focuses solely on end-of-life care.

Advance Directive (Advance Decision) encompasses a broader range of healthcare decisions, not just those related to life-sustaining treatment. It may include a Living Will, but it can also go further by:

• Detailing your preferences for various treatments and interventions
• Naming someone to make decisions on your behalf if you are unable to do so

In the UK, the role of appointing someone to make decisions on your behalf is covered by a separate document called a Lasting Power of Attorney for Health and Welfare.

Key Components of an Advance Directive

In the UK, an Advance Directive primarily includes:

Specific Treatment Refusals
You can refuse specific treatments, such as life-sustaining measures, under certain circumstances. For example, you might refuse resuscitation if you are in a permanent vegetative state.

Living Will (if applicable)
Within the Advance Directive, you can include a Living Will that focuses on end-of-life care and the treatments you wish to accept or refuse.

Lasting Power of Attorney for Health and Welfare
While not technically part of an Advance Directive, this is a separate legal document in which you appoint a trusted person (an attorney) to make healthcare decisions on your behalf if you are unable to do so. This can complement your Advance Directive by ensuring that your wishes are followed.

Why are Advance Directives Important?

Advance Directives are essential for maintaining control over your healthcare decisions, even when you can’t express them yourself. Here’s why they matter:

Personal Autonomy
These directives let you outline your healthcare preferences ahead of time, ensuring your wishes are respected even if you can't communicate them yourself.

Legal Clarity
These documents clear up any confusion for your family and healthcare providers when tough decisions need to be made. They lay out your wishes clearly, easing the emotional and practical burden on your loved ones during difficult times.

Avoidance of Family Arguments
Advance Directives can prevent painful family disputes by making your wishes explicitly clear. This helps ensure that your preferences are followed, reducing potential conflicts among relatives who might otherwise disagree about what’s best for you.

Legal Protection
These directives safeguard you from undergoing medical procedures that you wouldn't want.

Steps to Creating an Advance Directive

Creating an Advance Directive in the UK is a straightforward process but requires careful consideration to ensure it is legally valid and effective:

1. Understand the Components
   Familiarise yourself with the different elements of an Advance Directive, including specific treatment refusals and, if applicable, a Living Will.  
2. Consult with Your Doctor
   Although not legally required, it’s advisable to discuss your Advance Directive with a healthcare professional. This helps ensure that your decisions are informed by medical advice and that your wishes are clear and realistic.  
3. Draft the Document
   Write your Advance Directive clearly and precisely. Use straightforward language to avoid any ambiguity.  
4. Sign and Witness
   To be legally binding in England and Wales, your Advance Directive must be in writing, signed by you, and witnessed by someone who confirms that you signed voluntarily. The document should be dated to indicate when it was created.  
5. Distribute copies
   Provide copies of your Advance Directive to key individuals, including your family, GP, and anyone else who might be involved in your healthcare decisions. It’s important that these people know where to find the document if it’s needed.

Final Thoughts

Creating an Advance Directive is an important step in ensuring that your healthcare wishes are respected if you become unable to communicate them yourself.

While it may be an emotional process, it offers peace of mind, knowing that your preferences will be honoured, and it helps relieve your loved ones of the burden of making difficult decisions during challenging times.