ADVANCE MEDICAL DIRECTIVE

More commonly known as a ‘Living Will’, the Advance Directive (Refusal) is a document in which a person, whilst still in full possession of their faculties, makes known their preferences about future medical treatment and gives direction as to what should happen in the event of terminal or serious illness or injury.

Its purpose is to indicate to the Doctor the person’s wishes in regard to their health care in the event of there being no reasonable prospect of recovery or from a physical condition expected to cause severe distress or from a condition which may render the person incapable of rational existence i.e. an acceptable quality of life.

It is usually made with the object of ensuring that, should a patient find themselves in a state of terminal illness and incapacity, no procedures are used in which their life would be sustained or with the intent to prolong life. It would also ensure that if such procedures are already in place then these are withdrawn.

Competent, informed adults have an established legal right to refuse medical procedures in advance. An unambiguous and informed advance refusal is as valid as a contemporaneous decision. Health professionals are bound to comply when the refusal specifically addresses the situation which has arisen.

What is an Advance Statement about?

The purpose of an Advance Statement is for you to let other people know your own preferences about future medical treatment you would like to have, or wish to refuse, if you were in a condition which prevents you from making your views known.

What can an Advance Statement NOT include?

It is not possible for you to ask for anything in advance that you cannot currently demand. As an example, euthanasia (which is a medical intervention specifically intended to cause death), is illegal, and an Advance Statement cannot request medical staff to take active steps to terminate your life. Nor are you able to demand medical treatments which the Doctor considers to be inappropriate for you. Also there are certain aspects of basic care which you cannot refuse in an Advance Statement, such as: The offer of oral feeding and basic hygiene measures such as washing; the use of analgesics for pain relief.

Approved by the British Medical Association!

Advance Directives are now approved by the British Medical Association and are held to be legally binding on doctors.

The law fully supports the right of a patient to decline life-sustaining (or other) treatment and to receive analgesic drugs in quantities to relieve intolerable distress.

The Doctor should not asked to do anything contrary to his or her code of ethics or existing law, but should he or she be faced with a difficult decision regarding the prolongation of life, in the circumstances specified, above, it would be helpful to know of the wishes of the patient, particularly if they were expressed when the patient was in full possession of his or her faculties, and not in great pain.