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Governing Law

England
Built for England
Different countries have different rules and regulations. Your Advance Decision will be customised for England.


Frequently Asked Questions

In Scotland, a Living Will or Health Directive is legally referred to as an Advance Decision. In Scotland, an Advance Directive is not enforceable under the Adults with Incapacity (Scotland) Act 2000, however the Act states that the wishes of the person should be taken into consideration.Is my Advance Decision legally enforceable?In England and Wales, a Living Will or Health Directive is legally referred to as an Advance Decision. Advance Decisions are legally enforceable under the Mental Capacity Act 2005 and should be followed by healthcare professionals.In Northern Ireland, there is no specific legislation governing Advance Decisions. Status of Advance Decisions are therefore unclear and may not be enforced.


Your Advance Decision

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Advance Decision of ____________________

I, ____________________, of ____________________, ____________________, ____________________, England, being of sound mind and over the age of 18 years, make this Advance Decision fully understanding the consequences of my action in doing so. I intend this Advance Decision to be read by my health care providers, family and friends as a true reflection of my wishes and instructions should I become incapacitated and unable to communicate such wishes and instructions.

  1. DEFINITIONS

    As used in this document:

    1. "Health care provider" means any person licensed, certified or otherwise authorised by law to administer health care in the ordinary course of business or practice of a profession.
    2. "Terminal condition" means a condition caused by injury, disease or illness from which there is no reasonable medical probability of recovery and which, without treatment, can be expected to cause death.
    3. "Persistently unconscious" means being in a profound state of unconsciousness caused by disease, injury, poison or other means from which there exists no reasonable expectation of regaining consciousness.
    4. "Severely and permanently mentally impaired" means being in a permanent and irreversible state of mental impairment in which there is:
      1. The absence of voluntary action or cognitive behaviour; and
      2. An inability to communicate or interact purposefully with the environment.
    5. "Life support" means any medical procedure, treatment or intervention which sustains, restores or supplants a spontaneous vital function. In this document the term does not include tube feeding or the provision of medication or the performance of a medical procedure when such medication or procedure is deemed necessary to provide comfort care or to alleviate pain.
    6. "Tube feeding" means the provision of nutrients or fluids by a tube inserted in a vein, under the skin in the subcutaneous tissues, or in the stomach (gastrointestinal tract).
    7. "Cardiopulmonary resuscitation" means restoration of heartbeat and breathing following cardiac arrest, using artificial respiration and external cardiac massage.
    8. "Comfort care" means treatment, including prescription medication, provided to the patient for the sole purpose of alleviating pain and discomfort.
  2. TREATMENT DIRECTIONS AND END-OF-LIFE DECISIONS

    I direct that my health care providers and others involved in my care provide, withhold or withdraw treatment in accordance with my directions below:

    1. If I have an incurable and irreversible terminal condition that will result in my death within a relatively short time, I direct that:
      1. I not be given life support or other life-prolonging treatment;
      2. I not receive tube feeding even if withholding such feeding would hasten my death;
      3. I not receive cardiopulmonary resuscitation in the event of cardiac arrest; and
      4. Should I develop another separate condition that threatens my life, such other illness not be given active treatment unless it appears to be causing me undue suffering.
    2. If I am diagnosed as persistently unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, I direct that:
      1. I not be given life support or other life-prolonging treatment;
      2. I not receive tube feeding even if withholding such feeding would hasten my death;
      3. I not receive cardiopulmonary resuscitation in the event of cardiac arrest; and
      4. Should I develop another separate condition that threatens my life, such other illness not be given active treatment unless it appears to be causing me undue suffering.
    3. If I am diagnosed as being severely and permanently mentally impaired, I direct that:
      1. I not be given life support or other life-prolonging treatment;
      2. I not receive tube feeding even if withholding such feeding would hasten my death;
      3. I not receive cardiopulmonary resuscitation in the event of cardiac arrest; and
      4. Should I develop another separate condition that threatens my life, such other illness not be given active treatment unless it appears to be causing me undue suffering.
    4. If I should be in any of the above-mentioned conditions and if my behaviour is violent or otherwise degrading, I want my symptoms to be controlled with appropriate drugs, even if that would worsen my physical condition or shorten my life.
    5. If I should be in any of the above mentioned conditions and I appear to be in pain, I want my symptoms to be controlled with appropriate drugs, even if that would worsen my physical condition or shorten my life.
  3. GENERAL
    1. I understand that I may revoke this Advance Decision at any time either orally or in writing when I have capacity to do so.
    2. A copy of this Advance Decision has the same effect as the original.
    3. If any part or parts of this Advance Decision is found to be invalid or illegal under applicable law by a court of competent jurisdiction, the invalidity or illegality of such part or parts shall not in any way affect the remaining parts and this document shall be construed as though the invalid or illegal part or parts had never been included herein. But if the intent of this Advance Decision would be substantially changed by such construction, then it shall not be so construed.
    4. This Advance Decision is intended to be governed by the laws of England.


SIGNATURE

Signed at ____________________, ____________________, this 17th day of January, 2017.


______________________________
____________________
____________________
____________________
____________________
England
____________________
Birth date: 17 January 2017



STATEMENT OF WITNESS

I declare that:

  1. The individual who signed or acknowledged this Advance Decision, ____________________, is personally known to me or his identity was proven to me by convincing evidence;
  2. ____________________ appeared to be eighteen (18) years of age or older;
  3. I am of at least eighteen (18) years of age and ____________________ signed or acknowledged this Advance Decision in my presence;
  4. ____________________ appears to be of sound mind and under no duress, fraud, or undue influence;
  5. I am not ____________________’s health care provider, an employee of ____________________’s health care provider or the operator or employee of a nursing home or other residence for the elderly or handicapped in which ____________________ is a resident; and
  6. I am not related to ____________________ by blood or marriage and I would not be entitled to any portion of ____________________’s estate on his death.


Witness: #1

______________________________
Signature

______________________________
Print Name

______________________________
Address

______________________________
City, County

______________________________
Date

RECORD OF COPIES
Record of people and institutions to whom I have given a copy of this Advance Decision:

1.

________________________________________

Date: ____________________

2.

________________________________________

Date: ____________________

3.

________________________________________

Date: ____________________

4.

________________________________________

Date: ____________________

5.

________________________________________

Date: ____________________


Instructions for executing your Advance Decision

  1. Read the entire document before you sign in the space provided. Make sure it says what you want it to say.
  2. Each witness must watch you sign or be present when you acknowledge your signature.
  3. Do not leave any blank lines above your signature to be filled in after signing. Make sure there are no blank lines before you sign.
  4. Each page should be numbered. (e.g. 1 of 3, 2 of 3, etc.)
  5. You and your witness should initial all the pages.
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