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A Living Will, more accurately known in England and Wales as an Advance Decision to Refuse Treatment, allows you to record certain medical treatments you wish to refuse if you later lack the capacity to make or communicate that decision yourself. Lewis Nedas Law can advise on Advance Decisions, advance statements and Lasting Powers of Attorney as part of your future planning.
Call +44 20 7387 2032 for confidential advice or complete our online contact form to speak to our Wills, Trusts and Probate solicitors in London.
Call +44 20 7387 2032 Get in TouchPlanning for a time when you may be unable to make decisions for yourself can provide clarity for you, your family and the professionals responsible for your care.
Lewis Nedas Law has provided legal services for more than 40 years. The firm is authorised and regulated by the Solicitors Regulation Authority, SRA number 567461, and has received independent recognition as a Legal 500 Leading Firm 2026 and through inclusion in The Times Best Law Firms 2026.
Our Wills, Trusts and Probate team advises clients on Advance Decisions, advance statements, Lasting Powers of Attorney, Wills and wider later-life planning.
Mary is a Solicitor of England and Wales who advises on private client matters including Wills, probate, estate administration, Lasting Powers of Attorney and related planning for later life.
"Living Will" is an informal term commonly used for an Advance Decision to Refuse Treatment, sometimes shortened to ADRT. Under the Mental Capacity Act 2005, an Advance Decision allows a person aged 18 or over who has mental capacity to decide in advance that they wish to refuse a particular medical treatment in specified circumstances. The decision is intended to apply at a future point when the person lacks capacity to make the relevant treatment decision.
An Advance Decision is different from a conventional Will. A Will deals with matters arising after death, such as who should receive your estate. An Advance Decision concerns medical treatment during your lifetime. It does not appoint someone to manage your finances or make general decisions on your behalf.
An Advance Decision can be used to refuse specified medical treatment in particular circumstances. The treatment being refused needs to be identified clearly enough for healthcare professionals to understand what the decision covers.
For example, a person might wish to refuse a form of treatment if they have reached a particular stage of a serious condition and no longer have capacity to decide for themselves.
An Advance Decision cannot be used to demand a particular medical treatment. Clinical decisions remain subject to professional judgement and the applicable law. Careful drafting can be particularly valuable where treatment choices may depend on detailed medical circumstances.
Yes. An Advance Decision can refuse life-sustaining treatment if the statutory requirements are met. Life-sustaining treatment can include treatment that replaces or supports bodily functions, such as ventilation or cardiopulmonary resuscitation.
If an Advance Decision is intended to refuse life-sustaining treatment, it must:
Be in writing
Be signed by the person making it
Be witnessed
Include a clear statement that the decision applies where life is at risk
The treatment being refused and the circumstances in which the refusal should apply need to be identified. Discussing such decisions with a doctor or other appropriate healthcare professional can help establish the medical implications of the choices being recorded.
A valid and applicable Advance Decision can be legally binding under the Mental Capacity Act 2005. Whether it must be followed depends on questions including:
Whether the person was aged 18 or over when it was made
Whether they had mental capacity to make the decision
Whether the relevant treatment is clearly identified
Whether the circumstances described apply
Whether the Advance Decision has been withdrawn
Whether later actions are inconsistent with the decision
Whether a later Lasting Power of Attorney affects the position
Whether the additional rules for life-sustaining treatment have been met
An Advance Decision only operates where the person lacks capacity to make the relevant treatment decision at that time. If the person still has capacity, they can make their own decision about whether to accept or refuse treatment.
An advance statement is different from an Advance Decision. It can record your wishes, feelings, beliefs and preferences about your future care. Examples may include:
Where you would prefer to be cared for
Dietary preferences
Religious or cultural practices
Daily routines
Personal care preferences
People you would like to be consulted
Views about particular forms of care or treatment
An advance statement is not legally binding in the same way as a valid and applicable Advance Decision. Your recorded wishes and feelings must still form part of a best-interests decision where the Mental Capacity Act applies. An advance statement can provide useful guidance to family members, carers and healthcare professionals about what matters to you.
The distinction matters.
Records treatment that you do not want to receive in identified circumstances. If it is valid and applicable, it can be legally binding under the Mental Capacity Act 2005.
Records preferences, wishes, feelings and beliefs about your care. It can include requests about treatment, but it does not give a legal right to demand a particular treatment.
People sometimes use both documents so that they can record legally binding treatment refusals alongside broader wishes about their care. Our solicitors can explain the different legal effects before documents are prepared.
An Advance Decision is different from a Lasting Power of Attorney (LPA). An LPA allows you to appoint one or more people, known as attorneys, to make certain decisions on your behalf. There are two types of LPA in England and Wales:
A Health and Welfare LPA can give attorneys authority over matters such as:
Medical care
Day-to-day care
Where you live
Certain decisions involving life-sustaining treatment, where the LPA gives the required authority
A Health and Welfare LPA can only be used for a decision when you lack capacity to make that decision yourself.
A Property and Financial Affairs LPA deals with financial matters, which can include:
Bank and building society accounts
Bills and expenses
Property
Pensions and investments
Other financial affairs within the authority granted
Both forms of LPA must be registered with the Office of the Public Guardian before they can be used.
The timing and wording of an Advance Decision and a Health and Welfare LPA can affect which document governs a treatment decision. For example, an Advance Decision may no longer be valid in relation to particular treatment if a later Health and Welfare LPA gives an attorney authority to make that treatment decision.
A valid and applicable Advance Decision made after an LPA may restrict what the attorney can decide. Anyone considering both documents should make sure that their instructions do not conflict.
Legal advice can help coordinate an Advance Decision and LPA so that each document reflects the person's intentions.
They perform different functions. A Health and Welfare LPA appoints someone you trust to make certain decisions when you lack capacity. An Advance Decision allows you to make your own decision in advance to refuse specified medical treatment in identified circumstances.
Some people decide that one document meets their needs. Others use both. The suitable arrangement depends on the decisions you want to make in advance and the authority you want another person to have.
An Advance Decision can be withdrawn or changed when you have mental capacity to do so. A withdrawal does not always need to be in writing. The Mental Capacity Act permits an Advance Decision to be withdrawn at any time by a person with capacity, and a withdrawal may be made by any means. Different formalities apply when changes concern an Advance Decision refusing life-sustaining treatment.
For practical purposes, keeping healthcare professionals and people close to you informed about changes can reduce the risk of an outdated document being relied upon. You may wish to review the document following changes to your health, treatment options or personal circumstances.
Mental capacity is decision-specific and time-specific. A person may be able to make some decisions but not others. Capacity can change over time. Under the Mental Capacity Act 2005, a person must be presumed to have capacity unless it is established that they lack it.
An Advance Decision must be made at a time when the person has capacity to make the relevant decision. Where capacity may later be questioned, obtaining appropriate medical and legal input can provide clearer evidence of the circumstances in which the document was made. Further information about mental capacity and the Court of Protection is available on our website.
Lewis Nedas Law has provided legal services for more than four decades.
The firm is recognised as a Legal 500 Leading Firm 2026.
Lewis Nedas Law is included in The Times Best Law Firms 2026.
Our lawyers advise on Advance Decisions, Wills, LPAs, probate, trusts and estate planning.
Lewis Nedas Law Limited is authorised and regulated by the Solicitors Regulation Authority under SRA number 567461.
A Living Will usually means an Advance Decision to Refuse Treatment under the Mental Capacity Act 2005. It records specific medical treatment you want to refuse if you later lack capacity to make or communicate that decision yourself.
A valid and applicable Advance Decision can be legally binding. Extra formalities apply where it refuses life-sustaining treatment, including the requirement for a written, signed and witnessed document with a specific statement about life-threatening circumstances.
No. An Advance Decision deals with medical treatment only. A Property and Financial Affairs LPA can give an attorney authority over financial matters.
An Advance Decision can legally refuse specified medical treatment in identified circumstances. An advance statement records wider wishes and preferences about your care, which must be considered in any best-interests decision but is not legally binding in the same way.
Yes. You can change or withdraw an Advance Decision if you have capacity. Special formalities apply to decisions refusing life-sustaining treatment, and it is advisable to keep healthcare professionals informed of any changes to avoid an outdated document being relied upon.
Planning for future healthcare decisions can make your wishes clearer if you later lose capacity to communicate or decide for yourself. Lewis Nedas Law can advise on Advance Decisions to Refuse Treatment, advance statements, Health and Welfare LPAs and wider later-life planning.
Speak to our Wills, Trusts and Probate team by calling +44 20 7387 2032 or complete the firm's online contact form to arrange a confidential consultation with our London solicitors.
Call +44 20 7387 2032 Arrange a ConsultationThis page provides general information about Advance Decisions, advance statements and Lasting Powers of Attorney under the law of England and Wales. It does not constitute legal or medical advice. The effect of a document depends on its wording, individual circumstances and the law applying at the relevant time.
