Advance directives

An Advance Directive (or Advance Decision in England and Wales) is a formal document which enables you to refuse life-prolonging medical treatments or interventions, in the event where you cannot refuse them at the time. For example, because you are unconscious following a stroke, heart attack or car crash.

Many people are sure they would not want to be kept alive in a long-term coma-like state. A recent YouGov poll showed that 82% of people have strong views about their end-of-life treatment but very few (only about 4%) have made an Advance Directive/Decision.

Many people falsely believe that family members can make health care decisions on their behalf. In reality, unless you have appointed an Attorney to act on your behalf, decisions are made by your medical team. In Scotland, any decision they make must benefit you, and must take account of your past and present wishes and the views of the people close to you. An Advance Directive is the clearest way to make your wishes known.

Having end of life plans in place is of great benefit to everybody. Consider if you became ill, or were in an accident and lost the capacity to communicate. The doctors would have to decide what would benefit you, but this may not be what you wanted. Having plans in place will inform doctors of your wishes and your human rights will stand a much better chance of being respected, protected and fulfilled.

Knowing that doctors have a blueprint in place to guide them helps everyone involved. These plans help healthcare teams to act in a way which fulfils that person’s values. It also frees families and relatives from the pressure of having to make critical medical care decisions, especially while they are under stress or in emotional turmoil. Research shows that patients and their families report significantly less stress, anxiety and depression when an end of life plan is in place. It allows people to retain control of their decision making. It contributes to the wellbeing of everyone involved in your care.