Advance decisions to refuse treatment - during the advance care planning process a patient may decide they wish to express specific views about a particular treatment which they do not want to have. This particular wish can be expressed by making an advance decision to refuse treatment.
The Advance Decisions to Refuse Treatment: A Guide for Health and Social Care Staff was launched in September 2008. The purpose of this guide is to help health and social care professionals understand and implement the new law relating to advance decisions to refuse treatment, as contained in the Mental Capacity Act 2005. The Mental Capacity Act (MCA) came into force in 2007 and it is supported by a Code of Practice. Everyone must comply with the requirements of the Act.
Download an example proforma for My Advance Decisions to Refuse Treatment Form.
People and professionals might use this example or develop it to meet their own individual or local needs. There are other examples to be found but care is required to ensure that they comply with the legal requirements.
This guidance covers the law and ethical issues involved in competent individuals making advance decisions about their later medical treatment and proxy decisions about medical treatment made by other people on behalf of adults who lack mental capacity. When they are mentally competent, patients decide for themselves whether or not to accept the medical treatments recommended by health professionals. This guidance is about what happens when that mental ability to make a valid decision is lost.
(British Medical Association (BMA), June 2007)
The Mental Capacity Act (2005) makes new rules which must be followed when making advance decisions to refuse treatment. This booklet gives you guidance on how to make an advance decision within those rules.
(National End of Life Care Programme, May 2009)
The purpose of this guide is to help health and social care professionals understand and implement the new law relating to advance decisions to refuse treatment, as contained in the Mental Capacity Act 2005. The Mental Capacity Act (MCA) came into force in 2007 and it is supported by a Code of Practice. Everyone must comply with the requirements of the Act.
Download an example proforma for My Advance Decisions to Refuse Treatment Form.
People and professionals might use this example or develop it to meet their own individual or local needs. There are other examples to be found but care is required to ensure that they comply with the legal requirements.
(NHS National End of Life Care Programme, 02 September 2008 [File:2,960KB])
This site explains how the law now allows people to make decisions to refuse treatments including those that sustain life. Many people want to achieve a natural and dignified death, this is one way to help achieve it. This is a free and non-profit NHS website. ADRT training aims to allow professionals to:
* understand the legal context of ADRT
* understand the reasons why people might wish to make an ADRT
* help support patients in the process of making an ADRT
(NHS Advance Decision to Refuse Treatment)
This joint publication between NCPC and The Association of Palliative Medicine anticipates the Mental Capacity Act (2005) which is legally binding during 2007. It is a practical aid for all those who administer artificial hydration, explaining the terminology, rights and ethical framework; it also includes five case studies and various methods of dealing with ANH, from notifying decision-makers, to administering ANH in methods other than orally.
Author: Dr Richard Partridge and Dr Colin Campbell
N.B. Access requires NCPC website registration and log in.
(The National Council for Palliative Care and The Association of Palliative Medicine, ISBN: 978-1-898915-53-9, May 2007)
You must respect a patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational. You should explain your concerns clearly to the patient and outline the possible consequences of their decision. You must not, however, put pressure on a patient to accept your advice.
(General Medical Council, 2008)
Health professionals are aware that decisions about attempting cardiopulmonary resuscitation (CPR) raise very sensitive and potentially distressing issues for patients and people emotionally close to them. Some health professionals do not find it easy to discuss CPR with their patients, but this must not prevent discussion, either to inform patients of a decision or involve patients in the decision-making process, where appropriate. These guidelines identify the key ethical and legal issues that should inform all CPR decisions.
(British Medical Association (BMA), October 2007)
Implantable Cardioverter Defibrillators (Icds) In Patients Who Are Reaching The End Of Life is designed for health professionals. This booklet considers issues relating to ICDs in the management of advanced heart disease.
(British Heart Foundation , July 2007)
