Living Wills and advance medical decisions (AMD)

Living Wills are the colloquial term for Advance Medical Decisions (AMD).

An AMD is a document which enables you to set out your wishes as to what should happen if it is proposed that a person, usually a doctor, is to provide a specified treatment but you lack the capacity to consent to the treatment.

An AMD is legally binding on those concerned.

It is necessary to ensure that any advance decision will be recognised and applicable. An AMD can be used to refuse treatment and not ask for a specific treatment to be given. As you will appreciate, you cannot ask for any treatment which is against the law (ie assistance to commit suicide).

Often issues will be time critical and therefore the documentation needs to provide clear instructions and comply with all legal requirements.

We can assist with the preparation of an AMD and talk you through the various issues.

A Health and Welfare Lasting Power of Attorney (LPA) is a document by which you can appoint another person to make medical decisions on your behalf should you lose the ability to make decisions yourself. You can also use the LPA to give binding instructions or general guidance to your attorney(s) as to the medical decisions you would like them to make.

Both the AMD and the LPA work in practice. In some respects they are fairly interchangeable and there are elements in both that can cross over. For example, an AMD can in theory appoint someone to advocate on a person’s behalf in a similar fashion to an LPA. Alternatively an LPA can set out in writing specific restrictions and conditions in a similar fashion to an advance decision.

Both AMDs and LPAs have their own advantages and limitations. Each person’s needs will differ depending on their personal circumstances. We would therefore advise that you contact us and one of our specialist advisers can assist you.

As a general rule, we believe the following to be helpful ‘rule of thumb’ guidance:

• If you have very specific medical wishes and time is of the essence, an advance decision is sometimes the best option for clients. An example would be where a client has been diagnosed with a terminal illness and has a clearly defined understanding of what the future will hold for them and the specific treatments available.
• If your wishes are more general and you have close family members who you trust to make flexible and ongoing decisions on your behalf – an LPA is usually the better option.
• As a final note, the two documents are not mutually exclusive and can co-exist. In certain circumstances the best advice may be for a client to make both.