Adult Social Care Glossary, v 0.6

A decision to refuse specified treatment made in advance by a person who has capacity to do so. This decision will then apply at a future time when that person lacks capacity to consent to, or refuse, the specified treatment. Specific rules apply to advance decisions to refuse life sustaining treatment.

A decision to refuse specified treatment made in advance by a person who has capacity to do so. This decision will then apply at a future time when that person lacks capacity to consent to, or refuse, the specified treatment. This is set out in Section 24(1) of the Act. Specific rules apply to advance decisions to refuse life-sustaining treatment.

Advance decision to refuse one or more specific types of future treatment, made by a person who had capacity at the time of recording the decision. The decision only applies when the person no longer has the capacity to consent to or refuse the specific treatment being considered. An ADRT must be in writing, signed and witnessed. If the ADRT is refusing life-sustaining treatment it must state specifically that the treatment is refused even if the person's life is at risk.

A decision to refuse specified medical treatment, made in advance by a person who has the mental capacity to do so. In this way, people can refuse medical treatment for a time in the future when they may lack the capacity to consent to, or refuse, that treatment.

An advance decision to refuse treatment (sometimes referred to as a living will and sometimes abbreviated to ADRT) is a decision an individual can make when they have capacity to refuse a specific type of treatment, to apply at some time in the future when they have lost capacity. It means that families and health professionals will know the person's decisions about refusing treatment if they are unable to make or communicate the decisions themselves.

An advance decision must be valid and applicable before it can be legally binding. For example, one of the conditions is that the individual is aged 18 or over at the time the decision is made. To establish whether an advance decision to refuse treatment is valid and applicable, practitioners must have regard to sections 24 to 26 of the Mental Capacity Act 2005. If the advance decision purports to refuse life-sustaining treatment, additional requirements apply. (See Chapter 9 of the Mental Capacity Act Code of Practice.)

An advance decision to refuse treatment (ADRT) is a decision to refuse a specific treatment made in advance by a person who has capacity to do so. This decision only applies at a future time when that person lacks capacity to consent to, or refuse, the specified treatment. This is set out in section 24 of the Mental Capacity Act. Specific rules apply to advance decisions to refuse life-sustaining treatment.

An advance decision to refuse treatment:

- can be made only by someone over the age of 18 who has mental capacity
- is a decision relating to refusal of specific treatment and may also include specific circumstances
- can be verbal, but if an advance decision includes refusal of life sustaining treatment, it must be in writing, signed and witnessed and include the statement ‘even if life is at risk’
- will only come into effect if the individual loses capacity
- only comes into effect if the treatment and any circumstances are those specifically identified in the advance decision
- is legally binding if valid and applicable to the circumstances
- can be overridden by the Mental Health Act, but only for psychiatric treatment

A decision you make about what medical treatment you would or would not want in the future, if you were unable to make decisions because of illness or because you lacked capacity to consent. Unlike an advance statement, it is legally binding in England and Wales. If you are thinking about making an advance decision, you should talk about this with your family and your GP. SEE ALSO: Advance statement