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Advanced Decisions

What is a 'Living Will'?

A Living Will or, more accurately, an Advanced Decision allows a person over 18 years to refuse specified medical treatment for a time in the future when they might nor have the mental capacity to consent or refuse to that treatment.

Advanced Notices are commonly used where a patient with a known or predicted medical condition sets out their wishes – while they have the capacity to do so – regarding future treatment.  Typically this may be that an patient with a degenerative health problem may request that should they suffer a cardiac arrest, they are not resuscitated.

For a patient to refuse life sustaining treatment, the Advance Notice must be:

• be in writing (it can be written by someone else or recorded in healthcare notes);
• be signed and witnessed; and
• state clearly that the decision applies even if life is at risk.

In terms of a First Aider responding to a life threatening situation it is unreasonable to assume they would be aware of this written document.   It may be that a person known to the casualty attempts to prevent the treatment of First Aid if the casualty has made an Advanced Notice.  Again, it is difficult and unreasonable  for the First Aider to make a judgement about the validity of this claim.

Should any bystander attempt to prevent life-saving treatment of the casualty, the emergency services should be called as paramedics and other healthcare professionals can – in certain circumstances –  provide life saving treatment without or against consent. 

Further reading:  NHS - Advance Decisions

Excerpt taken from 'First aid & the law part 1 - Duty of care.