Advance Decisions, Advance Statements and Lasting Powers of Attorney: Make a wish and share it!
Recently my friend, Arthur, was admitted to a hospital having been diagnosed with a life-threatening illness as a result of which he went into a coma. His close family members were unaware of his wishes with respect to his future care and treatment. Many families find themselves facing this dilemma unless the afflicted person has organised their affairs in advance.
If you are unable to make informed decisions or communicate your wishes due to lack of mental capacity, for example, if you are unconscious following an accident or have dementia, then in such circumstances, a doctor has an obligation to act in your best interests (which may not be the same as your wishes) unless you have made an advance decision (often referred to as a ‘living will’) or have made a Lasting Power of Attorney for personal welfare. Both documents, to be valid, require that you have mental capacity and are over the age of 18. Arthur had made neither.
An advance decision is a decision made by you whilst you have mental capacity about a specific medical treatment you want to refuse in the future. It does not have to be in writing unless it is a decision to refuse life-sustaining treatment although a written decision always avoids any uncertainty. If such a document is prepared in accordance with legal formalities, is valid and applicable to the circumstances in hand, medical and healthcare professionals providing your care are bound to follow your wishes regardless of whether or not it is in your best interests. The important thing is that you make a choice for yourself and provided the conditions are satisfied, it prevails!
By making Lasting Powers of Attorney for personal welfare, you can choose someone you trust to make decisions about your care or treatment if you are unable to do so yourself and further, you can specify if you want your attorney(s) to have the power to make decisions to refuse or consent to life-sustaining treatment.
You could also state your wishes by making an advance statement which is more of a general statement describing your wishes, views and preferences. It allows you to indicate what treatment or care you would like to receive should you, in the future, be unable to decide or communicate your wishes for yourself including non-medical issues such as your food preferences or whether you would prefer a bath to a shower. It may be verbal or written. You could even record an advance statement in your Lasting Power of Attorney for personal welfare that you have created. It could also be made alongside an advance decision. The law requires that any advance statement must be taken into account when deciding what is in your best interests. However, such a statement is not legally binding. Even so, if only, Arthur had at least left such an informal statement for his family to refer to!
It is advisable to discuss with your GP or any medical team involved in your care so that they can assist you to understand the consequences of any decisions that you make. An accredited member of SFE can assist you in drafting the relevant documents so that your wishes are expressed correctly, any documents created are legally valid and continue to reflect your views and wishes. Lasting Powers of Attorney and advance decisions can both be cancelled at any time while you still have capacity to do so.
Expressing and recording wishes gives you peace of mind and takes the burden away from your loved ones. It really is time you shared that wish!