22 Apr 2024

Living wills and advanced decisions

When we think about wills, it’s often in the context of future decisions when we’re no longer around. But as we’ll explore, living wills are about how we’d like to be cared for while we’re alive.

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A living will notifies healthcare professionals of your refusal to receive certain treatments in the event you’re unable to communicate your wishes or make decisions yourself. It can take the form of a written document that you share with loved ones and healthcare staff, or you can express your wishes to your doctor.

Yes, living wills are sometimes known as an advance decision. You may also encounter the term ‘advance statement’, which refers to the written document in which you express your wishes regarding your future care.

Attitudes towards ‘life and death’ health decisions are deeply personal to each individual, but here are some reasons why you might consider making an advance decision.

  • You’ve been diagnosed with a serious illness, which has prompted you to draft a living will.
  • You want greater control over key medical decisions and how you’d like to be cared for.
  • You want clarity about your preferences and to reduce arguments among loved ones.
  • You have a high-risk job and want to have a plan in place for a worst case scenario.
  • You choose to reject life-sustaining medical interventions on spiritual or religious grounds.

A living will or advance decision is legally binding in England, Wales and Northern Ireland so long as the correct process has been followed. While living wills are not legally binding in Scotland, a doctor will often follow the instructions in the advance statement.

How to make a valid living will

For a living will to be considered valid, the following should apply:

  • The living will document is signed by you, and if you wish to refuse life-sustaining treatment, a witness as well.

  • You have clearly stated which treatments you would reject, why you would refuse them, and in what circumstances.

  • You have the capacity to make the decision yourself.

  • You have not made any statements or performed any actions that would contradict your living will wishes.

  • Your living will must comply with the Mental Capacity Act, which is intended to protect those who lack mental capacity with regards to their health decisions.

If you’re in a critical condition, life-sustaining treatments are designed to keep you alive by replacing bodily functions with medical interventions. This includes being on a ventilator to assist your breathing, as well as antibiotics and CPR.

Making an advance statement - step by step

Before you commit to making an advance decision, here is a summary of the process you may want to follow.

 

  1. Decide what to include. Before you make a living will decision, you should think about what treatments you would refuse, as well as your grounds for refusal.

  2. Inform your loved ones. You might wish to discuss your wishes with your family or close friends so that they can advocate on your behalf if you’re unable to communicate following a medical event.

  3. Make your statement. You can either inform your doctor of your advance decision or write your advance statement (using the help of a solicitor if you wish). You can create an advance statement online or through a paper form – scroll to the bottom of this guide for more resources.

  4. Get it signed by a witness. If your advance decision involves refusing life-sustaining treatment, your living will would need to be in written form and include the signature of a witness.

  5. Share your living will. In a medical emergency, it’s important that health professionals are aware of your wishes. You should share your living will with loved ones and your doctor. You could also keep your advance statement in a clearly marked envelope in your bag.

  6. Review your decision. If your feelings about your living will change in the future, you can change your wishes or revoke the decision at any time.

Your living will can include an advance statement which details your preferences regarding future care decisions. Here are some examples of what you could include.

  • Your name, address and date of birth.
  • Your NHS number.
  • Your values or philosophy that inform your advance decision.
  • The treatments that you would refuse, and in what circumstances.
  • Details of any people you’ve appointed as a Lasting Power of Attorney.
  • Details of any healthcare professionals you’ve discussed the decision with.
  • Any distinguishing physical marks that could help identify you following an emergency.

You must be 18 years old or above in order to make a living will. If you wish to do so, it’s important that you get it done while you have ‘capacity’ in order for the advance decision to be valid.

You don't need to use a solicitor in order to make a living will. Some people choose to appoint a solicitor to help them draft their advance statement and provide specialist legal advice.

If you use a solicitor, it often takes between two and four weeks to create a living will. A solicitor might be able to complete it sooner if your needs are urgent.

You can expect to pay around £200-£250 if you use a solicitor to create a living will. But in theory, you can do it yourself for free

How to change a living will

You can update your living will at any time. If you wish to make minor alterations, you can simply amend the information in your advance statement and write your initials and the date. For more substantial changes, such as the refusal of treatment, you would need to get the document re-signed and witnessed again. You may wish to make an advance decision from scratch in a new document so that your wishes are clear.

No, your living will would not have an impact on your life insurance policy. A valid life insurance policy pays out upon death, even if you refuse life-sustaining treatments.

Extra support for making a living will

Find out more about Over 50 Life Insurance

Meet our expert
Nicola Giles - Life Technical Consultant

Nicola Giles

Life Technical Consultant, Legal & General, Retail Protection

As a Life Technical Consultant, Nicola helps people within and beyond Legal & General get to grips with and follow all relevant trust and taxation legislation. There’s a lot of detail in her job, whether she’s going over the legislation itself or making sure that it’s being properly followed. She looks to cover it extraordinarily well!

More about Nicola

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