living wills how to ensure your wishes are known when you can no

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living wills
how to ensure your
wishes are known
when you can no
longer make yourself
understood
what do you need?
a lasting power of attorney, living will or
advance statement?
a draft living will form for your use
also
informed consent to treatment
why it is important
do not resuscitate orders
their implications for patients and family
What is The Patients Association?
Our Aims
The Patients Association listens to the concerns of patients
and focuses all its work on what matters to them. We are
the first port of call for many who seek help with their health
care problems. We aim to empower them to make informed
choices and speak up for themselves with confidence and
conviction. The Patients Association, established in l963, is
a national voluntary organisation and registered charity. It is
run by an elected Council and is completely independent of
government, although we work with them on specific projects
for a better and more responsive service.
• “listening to patients and speaking up for change”
The NHS exists for patients; it is there to serve them. We
represent all patients – and we are all patients sooner or later.
What can we do for you?
• Advice to patients through fact sheets, good practice material and
self-help guides
• Speak up for patients to government, health professionals and managers
and elected representatives from Westminster to local councils
• Campaign for improved health services from the patient’s point of view
so that a consumer-led health system provides the most effective and
efficient service
• Provide individual confidential practical guidance on all health services
whether NHS or private
• Provide a platform for patients to influence the health agenda of the UK
through our regular Taking the Pulse surveys
• Publish accurate up to date advice through our library of information
• Speak up for change to the media on the basis of what you tell us
• Offer local activities through our Eyes and Ears health network
• Convey your views to other charities through our Network for Patients
Please note that we cannot give clinical advice
Join us at
www.patients-association.com
or call
0208 423 9111
Helpline
0845 698 4455
1
Contents
2
Consent to treatment
4
Do not resuscitate orders
20
What is it? What the law says
4
What does DNR mean?
20
What information do I need?
4
When does it happen?
20
Who should provide it?
5
What risks should I know about?
5
Should the family be consulted?
20
What about my specific questions?
5
Appropriate use of DNR’s
21
Questions to ask your Doctor
5
Who takes the decision? 21
Can I refuse treatment?
6
Safeguards
21
Can I insist on specific treatment?
6
What if I lost the ability to make decisions for myself?
6
Useful addresses
22
Can children make decisions about medical treatment
6
What does a consent form look like? 7
Draft Living Will form
24
Living Wills
12
What are they and why are they important?
12
How the Mental Capacity Act 2005 changed things in
England and Wales
12
What happens in Scotland and Northern Ireland?
13
Powers of the Court of Protection
14
Lasting Power of Attorney and Enduring Power of Attorney
14
Specific situations and treatment
15
What a Living Will cannot ask for
16
Do I need to consult anyone about a Living Will
16
Do I need to tell anyone once I have made a Living Will
17
Conditions for validity
17
Charges
18
Interaction of Living Wills and Lasting Powers
18
Special rules applying to life sustaining treatment 18
3
Consent to Medical Treatment
What is it? What the law says - In England and Wales
Consent is central to medical treatment. Consent means
more than simply agreeing to have a particular course of
treatment or a medical procedure. It signifies that by signing
the consent form the patient understands what the treatment
will involve and what the anticipated benefits and risks
of treatment are and that the consent has been given
without duress.
A patient is competent if he or she can: comprehend
information presented in a clear way, believe it and remember
it long enough to consider it and come to a decision.
What information do I need to give consent?
Who should provide it?
It is the responsibility of the doctor providing the treatment to ensure you have
been given the appropriate information. Good practice states that the doctor
should do this, and seek your consent. It is acceptable for someone else
to do this on their behalf, provided they are suitably trained and qualified to
know the treatment or procedure in question.
What risks should I know about?
Doctors should tell you about frequently occurring risks associated with the
treatment you need, even if small. They are not expected to tell you about
every possible risk. They should tell you about any serious side-effects or
complications, even if there is only a small chance of them happening. All of
this should be explained in clear language, and your doctor should check to
ensure you have understood properly.
What about my specific questions?
The information necessary for consent will vary according
to the proposed treatment or procedure and the individual
patient’s needs. There are standard points that should
always apply:
You are entitled to ask questions about your treatment and your doctor is
under a duty to answer honestly and, as far as possible, in as much detail as
you require.
• The diagnosis, prognosis, further investigations that
may be necessary and what they consist of
Possible questions to ask your doctor
• Explanation of the treatment options, including having
no treatment
• The risks and benefits of each option including the risk
of success or failure
• Details of who will be involved in your treatment and
what each will do
• Your right to a second opinion if you are unhappy with
the current advice being given
• Who will provide the treatment or perform the surgery?
• How much experience does the person providing the treatment have?
For example, how many procedures have they performed in the last year
and what was the complication rate?
• What are the likely risks and benefits associated with the procedure?
• What is the risk of the procedure not working at all? Is there any other
treatment possible?
• What are the alternatives and their risks and benefits?
• What is the rate of healthcare acquired infection on this ward now?
• What aftercare in the community can I expect if something goes wrong?
4
5
Can I refuse treatment?
What does a consent form look like?
Yes – if you are aged 18 years or older, and have mental
capacity (sufficient understanding to make decisions about
medical treatment) no one can make a decision on your
behalf. The right to refuse treatment is absolute and such
decisions have to be respected.
Consent forms will vary from hospital to hospital and Trust to Trust. The
Patients Association continues to campaign for a standard NHS form and for
patients to have proper time to study the form in advance of the treatment or
procedure to which it relates.
Can I insist on specific treatment?
No – doctors or other healthcare professionals cannot
be made to provide treatment which they consider to be
inappropriate or unnecessary. You are entitled to choose
between different treatments if more than one option is
available, or to decline treatment altogether.
You should feel free to ask to see the consent form before your admission.
Some clinicians already give patients the consent form in this way and
patients can encourage others to do the same just by asking.
Consent Form Sample below
Patient agreement to investigation or treatment
Patient details (or pre-printed label)
What if I lost the ability to make decisions for myself?
In the absence of a Living Will or Lasting Power of Attorney
– Health and Welfare, doctors are required to act in the best
interests of their patient.
Patient’s surname/family name..........................................................................................
Patient’s first names...........................................................................................................
Date of birth........................................................................................................................
Responsible health professional........................................................................................
Can children make decisions about medical treatment?
Yes – in some situations, but the courts can authorise
treatment against a child’s wishes if it is in the child’s best
interests. Children aged 16 years or older can consent to
undergo medical treatment including surgery even if their
parents do not agree. For children under the age of 16, there
is not the same legal right to consent to treatment, but if they
are considered to be mature enough to give consent a doctor
can provide treatment.
Job title...............................................................................................................................
NHS number (or other identifier)........................................................................................
 Male
 Female
Special requirements.........................................................................................................
(eg other language/other communication method)
To be retained in patient’s notes
Patient identifier/label
Scotland
See page 9
Name of proposed procedure or course of treatment (include brief explanation if
medical term not clear)......................................................................................................
Northern Ireland
See page 9
6
...........................................................................................................................................
7
Statement of health professional
(to be filled in by health professional with appropriate knowledge of
proposed procedure, as specified in
consent policy)
Statement of interpreter (where appropriate)
I have explained the procedure to the patient.
In particular,~ I have explained:
Signed:......................................................................... Date:.............................................
I have interpreted the information above to the patient to the best of my ability and in a
way in which I believe s/he can understand.
Name (PRINT)....................................................................................................................
The intended benefits
...............................................................................................................
...............................................................................................................
Serious or frequently occurring risks
...............................................................................................................
...............................................................................................................
Any extra procedures which may become necessary during the
procedure
 blood transfusion...............................................................................
 other procedure (please specify)
...............................................................................................................
I have also discussed what the procedure is likely to involve, the
benefits and risks of any available alternative treatments (including
no treatment) and any particular concerns of this patient.
 The following leaflet/tape has been provided
...............................................................................................................
This procedure will involve:
Top copy accepted by patient: yes/no (please ring)
Statement of patient
Patient identifier/label
Please read this form carefully. If your treatment has been planned in advance, you
should already have your own copy of page 2 which describes the benefits and risks
of the proposed treatment. If not, you will be offered a copy now. If you have any
further questions, do ask – we are here to help you. You have the right to change your
mind at any time, including after you have signed this form.
I agree to the procedure or course of treatment described on this form.
I understand that you cannot give me a guarantee that a particular person will perform
the procedure. The person will, however, have appropriate experience.
I understand that I will have the opportunity to discuss the details of anaesthesia with
an anaesthetist before the procedure, unless the urgency of my situation prevents this.
(This only applies to patients having general or regional anaesthesia.)
I understand that any procedure in addition to those described on this form will only
be carried out if it is necessary to save my life or to prevent serious harm to my health.
I have been told about additional procedures which may become necessary during
my treatment. I have listed below any procedures which I do not wish to be carried out
without further discussion.
 general and/or regional anaesthesia
 local anaesthesia
 sedation
...........................................................................................................................................
Signed:................................................. Date:........................................
Name (PRINT)....................................................................................................................
Name (PRINT):..................................... Job title:...................................
A witness should sign below if the patient is unable to sign but has indicated his or her
consent. Young people/children may also like a parent to sign here (see notes).
Contact details (if patient wishes to discuss options later)
...............................................................................................................
Signed:......................................................................... Date:.............................................
Patient’s signature........................................................ Date:.............................................
Name (PRINT)....................................................................................................................
8
9
Confirmation of consent (to be completed by a health professional
when the patient is admitted for the procedure, if the patient has
signed the form in advance)
On behalf of the team treating the patient, I have confirmed with the
patient that s/he has no further questions and wishes the procedure
to go ahead.
Signed:................................................. Date:........................................
Name (PRINT):..................................... Job title:...................................
Important notes: (tick if applicable)
 Patient has withdrawn consent (ask patient to sign /date here)
When NOT to use this form
If the patient is 18 or over and is not legally competent to give consent, you should
use form 4 (form for adults who are unable to consent to investigation or treatment)
instead of this form. A patient will not be legally competent to give consent if:
...............................................................................................................
• they are unable to comprehend and retain information material to the decision
 See also advance directive/living will (eg Jehovah’s Witness form)
Guidance to health professionals (to be read in conjunction with
consent policy)
What a consent form is for
This form documents the patient’s agreement to go ahead with
the investigation or treatment you have proposed. It is not a legal
waiver – if patients, for example, do not receive enough information
on which to base their decision, then the consent may not be valid,
even though the form has been signed. Patients are also entitled to
change their mind after signing the form, if they retain capacity to do
so. The form should act as an aide-memoire to health professionals
and patients, by providing a check-list of the kind of information
patients should be offered, and by enabling the patient to have a
written record of the main points discussed. In no way, however,
should the written information provided for the patient be regarded
as a substitute for face-to-face discussions with the patient.
The law on consent
See the Department of Health’s Reference guide to consent for
examination or treatment for a comprehensive summary of the law
on consent (also available at www.doh.gov.uk/consent).
Who can give consent
Everyone aged 16 or more is presumed to be competent to give
consent for themselves, unless the opposite is demonstrated.
If a child under the age of 16 has “sufficient understanding and
10
intelligence to enable him or her to understand fully what is proposed”, then he or
she will be competent to give consent for himself or herself. Young people aged 16
and 17, and legally ‘competent’ younger children, may therefore sign this form for
themselves, but may like a parent to countersign as well. If the child is not able to
give consent for himself or herself, some-one with parental responsibility may do so
on their behalf and a separate form is available for this purpose. Even where a child
is able to give consent for himself or herself, you should always involve those with
parental responsibility in the child’s care, unless the child specifically asks you not to
do so. If a patient is mentally competent to give consent but is physically unable to
sign a form, you should complete this form as usual, and ask an independent witness
to confirm that the patient has given consent orally or non-verbally.
and/or
• they are unable to weigh and use this information in coming to a decision.
You should always take all reasonable steps (for example involving more specialist
colleagues) to support a patient in making their own decision, before concluding that
they are unable to do so.
Relatives cannot be asked to sign this form on behalf of an adult who is not legally
competent to consent for himself or herself.
Information
Information about what the treatment will involve, its benefits and risks (including sideeffects and complications) and the alternatives to the particular procedure proposed,
is crucial for patients when making up their minds. The courts have stated that
patients should be told about ‘significant risks which would affect the judgement of a
reasonable patient’. ‘Significant’ has not been legally defined, but the GMC requires
doctors to tell patients about ‘serious or frequently occurring’ risks. In addition if
patients make clear they have particular concerns about certain kinds of risk, you
should make sure they are informed about these risks, even if they are very small or
rare. You should always answer questions honestly. Sometimes, patients may make
it clear that they do not want to have any information about the options, but want you
to decide on their behalf. In such circumstances, you should do your best to ensure
that the patient receives at least very basic information about what is proposed. Where
information is refused, you should document this on page 2 of the form or in the
patient’s notes.
11
LIVING WILLS
What are they and why are they important?
A Will is a statement of what you want done with your property
after you die. Making a Will ensures certainty after your death
so that those whom you wish to inherit your property can do
so in an orderly way and avoid confusion or dispute.
A Living Will (which is the same as an Advance Directive or
Advance Decision) is a statement of what health treatment
you want or do not want once you lack the mental capacity
to tell people for yourself. It is designed to ensure that in the
event that your capacity to make clear your own views is
no longer present, your views are nonetheless clear to your
family and clinicians, again to avoid confusion or dispute.
The importance of Living Wills has grown as medicine has
advanced and life is preserved where previously death would
have been inevitable. How that life is lived and whether or
not it is perceived as having sufficient quality lies behind the
desire of individuals to decide what is worthwhile in advance
of the actual situation.
How the Mental Capacity Act 2005 changed things in
England and Wales
Living Wills have been around for some time. Such
documents were helpful to a relative required to make
life-affecting decisions on behalf of someone unable to
communicate effectively. They were accepted as legal and
binding. It was unlawful to ignore a Living Will or Advance
Directive if the circumstances exactly matched those in
the directive. However one great problem was that the
appointment of someone to make decisions for you was not
binding. All you could do was to appoint a Health Care Proxy
who could represent your views but who could be ignored by
those treating you.
12
The Mental Capacity Act, which came into force in England and Wales
in 2007, changed this. It provides for the first time a statutory basis for
Living Wills (the previous law was based on common law principles) and
a framework which enables you to consider and record in advance how
you wish to be treated when you are unable to express your own views. In
particular, you can appoint a Welfare Attorney and set out your own views and
specifically state whether or not your Welfare Attorney may make decisions
on your behalf about acceptance and refusal of life sustaining treatment.
What happens in Scotland and Northern Ireland
Please note the Mental Capacity Act 2005 does not apply in:
Scotland: where the Adults with Incapacity (Scotland) Act 2000 introduced a
system for safeguarding the welfare and managing the finances and property
of adults (age 16 and over) who lack capacity. It allows other people e.g.
doctors, to make decisions on behalf of these adults, subject to safeguards.
The Act aims to ensure that solutions focus on the needs of the individual.
Thus the continuing debate in Scotland about whether Living Wills should
have overriding authority appears to have decided that they should not
despite the Act making no explicit reference to them.
Northern Ireland: where currently there is no law permitting Living Wills.
For further information we advise you to contact Age Concern.
(see Address Book)
The Mental Capacity Act has a Code of Practice that provides guidance, not
only for making an advance decision, but for those who may have to act upon
one – relatives or medical staff. It explains how to assess whether someone is
mentally competent to make a particular decision, and also what it means to
“act in someone’s best interests”. Chapter 9 of the Code gives a very helpful
explanation of how Living Wills interact with Lasting Powers of Attorney –
Health and Welfare.
The Code is as important for those called up to act upon an advance
decision as for those making one, because a doctor is always under an
obligation to make sure that patients consent to treatment. But if someone is
admitted to hospital when unable to make or communicate decisions about
treatment, then medical staff are under a professional obligation to act in that
patient’s best interests as they see it. In such cases, knowing the patient’s
13
view of best interests becomes crucial. The existence of an
advance decision refusing the proposed treatment overrides
any obligation for carers to decide for themselves what is in
a patient’s best interests. In those circumstances they must
respect the patient’s stated wishes even if it leads to that
person’s death. It is legally binding.
The importance of Living Wills is shown when there is no
advance decision. Medical Staff will almost certainly do
their utmost to keep the patient alive at all costs. They may
do this even when a relative is convinced this is not what
the patient would have wanted. If there is a question of the
patient’s mental capacity then, in the absence of an advance
decision made by the patient when of sound mind, the Mental
Capacity Act provides a mechanism to allow someone to be
appointed to act on their behalf. The Court of Protection was
set up to do this.
Powers of the Court of Protection
The Court of Protection has a long history but when the
Mental Capacity Act came into force in 2007, the old court
was abolished and a new Court (confusingly given the same
name) established. Its purpose is to safeguard the interests
of anyone with limited mental capacity and in particular to
manage the affairs of those who have not made Lasting
Powers of Attorney and who have lost the capacity to
manage their own affairs. The Court will find itself arbitrating
in disputes between family members over who should
take charge.
Lasting Power of Attorney and Enduring Power of Attorney
As the Office of the Public Guardian (see address book))
makes clear, Lasting Powers of Attorney (LPA) are very
important documents. You need to have complete trust in
those to whom you give such a power that they will act in
your best interests. You are strongly advised to take
professional advice.
14
You may have taken out an Enduring Power of Attorney (EPA) in the past.
The Mental Capacity Act replaces EPAs with a different power of attorney
called a Lasting Power of Attorney (LPA). You cannot make any changes to
an existing EPA, or take out a new one, but if you already have one you can
make a Health and Welfare LPA to run alongside the EPA. It is essential to
understand that an EPA deals with finances and property only. It gives no
authority whatsoever to make health and welfare decisions. A new Lasting
Power (whether for Property and Affairs or for Health and Welfare) must be
registered with the Office of the Public Guardian before it can be used. That
is an absolute requirement and there is no way round it. It can be registered
by you or by the person(s) to whom you have given the Power. An EPA
created before 01/10/2007 can still be registered by your Attorney(s) if they
have reason to believe that you are or are becoming mentally incapable of
managing your affairs. It cannot be registered by you.
You may therefore decide that you will need two forms of LPA: one to cover
who should have responsibility for managing your financial affairs, and
another for who should oversee health or welfare matters – like where you
are to live, obtaining access to your medical records, and above all, having
authority to refuse or consent to life-sustaining treatment when you are near
death. An LPA does not need to be drawn up by a lawyer but for such an
important document it is sensible to take qualified advice, and there will be a
fee payable, as well as a registration fee which must be paid to the Office of
the Public Guardian
Unlike the old EPA, as any LPA must be registered with the Office of the
Public Guardian before it can be used, you should look for detailed guidance
and advice on the website: www.publicguardian.gov.uk
Living Wills must relate to specific situations and treatments
Situations will include:
• being unconscious and unlikely to regain consciousness
• suffering from an incurable or irreversible condition likely to result in
death within a short period
• disability either physical or mental so severe that you will be totally
dependent on another permanently
15
Treatments will include
• where burdens and risk outweigh potential benefit
a Health and Welfare LPA really understand your feelings about pain, dignity,
and quality of life.
• research or experimentation unlikely to benefit you personally
Do I need to tell anyone once I have made a Living Will?
• those which postpone death
You should make sure it is added to your medical notes so that it can be
found easily. Give copies to your GP, next of kin, executors of your Will and
your solicitor. We suggest you carry a card with you, similar to an organ
donation card, which at the least informs people that your Living Will exists
and where it may be found. You will find one at the end of this guide. The
important factor in all of this is that your views are known and accessible at
the time they are needed.
and specific treatments to which you consent
• being fed or hydrated, but not by drip
• to make you more comfortable
• to safeguard your dignity
• to relieve pain even though it may hasten death – this is
helpful to cover the vague area between effective and
fatal pain relief.
Your wishes on organ donation may also be covered.
What are the conditions for a Living Will or Lasting Power of Attorney
to be valid?
You must be over 18, and mentally competent. The information contained
in your Living Will should ideally include:
• Full name and address
What a Living Will cannot ask for
• Name, address and telephone number of your GP
You cannot insist on a specific treatment. Clinical decisions
are for the doctors at the time they have to be made.
Euthanasia is illegal in the UK at present, so you cannot ask
for a specific treatment that you know would kill you.
• Date and your signature
Do I need to consult anyone about a Living Will?
No. However discussing such issues as Living Wills or
Lasting Powers of Attorney are as important as the making of
a Will, for the reasons previously stated.
Discussion with a doctor will enable you to understand the
options for treatment if they arise and help you formulate in
your own mind what you do or do not wish to consent to.
Remember Living Wills or Lasting Powers of Attorney (LPA)
are for use in the eventuality that you are unable to make a
decision. You must ensure the person(s) you choose to hold
16
• Date and signature of at least one witness over 18. Such a witness should
not be a spouse, relative or partner, or a beneficiary of your Will or if a LPA,
the attorney.
• If you have decided to nominate someone to be consulted about
treatment decisions or are writing a Lasting Power of Attorney, you need to
include their name, address, and telephone number
• Statement of your values and wishes
• Treatment you are refusing (for refusal of life saving treatment please see
page 14: Special Rules that apply to life sustaining treatment).
• Clear statement of the medical situations which will activate it
• It is strongly recommended that you review what you have written on a
regular basis, to ensure you still feel the same way. If you make any
revisions, they should be signed, dated and witnessed.
17
Charges
If you use the services of a solicitor to draw up a Living Will,
charges may range from £120 to £250 plus VAT, assuming it
is straightforward.
• Verbal Living Wills do NOT apply to life sustaining treatment – see the
Code Chapter 9 paragraphs 24 to 28.
A Lasting Power of Attorney should ideally be drawn up by a
solicitor, and one used to this type of work. Charges will be
more and there is a fee payable of £120 for registration of
each type of Power.
Interaction between Living Wills and Lasting Powers
You should be aware that a Living Will overrules the terms of
any Personal Welfare LPA signed before the Living Will, so
an attorney under a Health and Welfare LPA cannot consent
to any treatment which has been refused in a Living Will
made AFTER the LPA was signed. But an LPA made after
the Living Will will make the Living Will invalid IF the LPA
gives the attorney the right to make decisions about the
same treatment.
Special rules applying to life saving or life
sustaining treatment
You should also be aware that if you wish to refuse lifesustaining treatment in advance special provisions apply.
• Your statement must be in writing (not necessarily yours),
as if you are too ill to write it may be written down at
your direction
• It must be signed, and if you cannot sign it may be signed
at your direction
• It must be witnessed and the witness must sign in the
presence of the person making the Living Will
• It must include an unambiguous written statement that the
decision is to apply to the specific treatment even if life is
at risk
18
19
Do Not Resuscitate Orders
Appropriate use of DNR’s
What does DNR mean?
The most difficult decisions involve patients who know they are terminally
ill, are suffering a lot of pain for example, but who could continue to live for
several months.
Do Not Resuscitate orders or DNR’s mean that a doctor is not
required to resuscitate a patient if their heart stops. They are
designed to prevent a patient’s unnecessary suffering but are
regarded by some as a form of euthanasia.
When does it happen?
These orders may also be put on a patient’s file if the resuscitation would
be unlikely to succeed, if the patient has stated they do not want to be
resuscitated e.g in a Living Will or by being consistent in stating their view.
The order may also be made if the clinical view is that it is not in the patient’s
best interest. This is the most controversial reason for families and carers to
accept because of its subjective nature.
They will be placed on a patient’s file if the clinical judgement
is that resuscitation will not be appropriate:
Who takes the decision?
• If it will not restart the heart or breathing
• When there is no overall benefit to the patient
• When the patient has previously indicated that they do not
want resuscitation (as in a Living Will)
• They are intended to prevent additional pointless suffering
from the effects of the resuscitation itself, such as broken
ribs or other fractures, ruptured organs or brain damage.
Should the family be consulted?
Both the British Medical Association and the Royal College
of Nursing have guidance which says that families should be
involved in any discussion on DNR orders. There may well be
sensitivities, difficulty and distress but that is no reason not to
talk to families.
20
The professional guidance was drawn up following concerns that junior
doctors were taking decisions in the absence of consultants. You should feel
free to ask about the individual hospital’s procedures at the outset, rather
than defer until a decision appears likely to be made. DNR’s should not be
put in patients’ notes solely on the grounds of age.
Safeguards
Each NHS Trust must have a policy in place which has patients’ rights at its
core, overseen by a non-executive director. It must be available easily for all
concerned, monitored and audited. You should not be deterred from asking
about this at any stage. Some hospitals may ask patients for their views
when they first come into hospital. DNRs should be reviewed regularly, and
especially if the patient’s condition changes.
21
Address Book
ALZHEIMER’S SOCIETY
Devon House, 58 St. Katharine’s Way, London E1W 1JX
Tel: 0207 423 3500 Fax: 0207 423 3501
Email: enquiries@alzheimers.org.uk
www.alzheimers.org.uk
OFFICE OF THE PUBLIC GUARDIAN
PO Box 15118, Birmingham B16 6GX
Tel: 0300 456 0300 Mon-Fri, 9-5 (Wed 10-5)
Fax: 0870 739 5780
Email: customerservices@publicguardian.gsi.gov.uk
www.publicguardian.gov.uk
LAW SOCIETY OF SCOTLAND
Tel: 0131 226 7411 Fax: 0131 225 2934
www.lawscot.org.uk
DIRECT GOV
www.direct.gov.uk
official government website for Living Wills, Wills, LPA’s etc.
SCOTTISH GOVERNMENT
www.scotland.gov.uk
OFFICE OF THE PUBLIC GUARDIAN – SCOTLAND
Hadrian House, Callendar Business Park,
Callendar Road, Falkirk FK1 1XR
Tel: 01324 678300 Fax: 01324 678301
Email: opg@scotcourts.gov.uk
www.publicguardian-scotland.gov.uk
AGE CONCERN NORTHERN IRELAND
3 Lower Crescent, Belfast BT7 1NR
Tel: 028 9024 5729 Fax: 028 9023 5497
Email: info@ageni.org
www.ageni.org
LAW SOCIETY
Tel: 0207 242 1222 Fax: 0207 831 0344
www.lawsociety.org.uk
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Below are outline suggestions for a Living Will and also a
Living Will card (which may be carried with you as with an
organ donor card). Please remember that the information,
especially telephone numbers, on both, must be kept up to
date. You should also revise your Living Will regularly to ensure
it states your current view in the light of medical technology.
Living Will Card
I ..................................................... NHS No: ..........................
have made a Living Will which may be obtained from
Name . ........................................... Tel . ...................................
or
If I am incapable of directing, participating effectively in or consenting to
treatment, I direct that:
1.
I do not want my life prolonged by medical treatment, procedure or
intervention if, in the opinion of the consultant in charge of my care and
another doctor, to do so would not result in my recovery and/or the
severity of my illness means my life is nearing its end.
2. I do want pain relief, even if such treatment may shorten my life.
Or you may wish to state instead:
3. I wish to be kept alive for as long as possible using all medical treatments,
procedures and interventions available.
You may also wish to add a clear statement of your values or religious
beliefs on which your decision is based.
Name . ........................................... Tel . ...................................
I have appointed the following as my Health and Welfare Attorney(s) under
my Lasting Power of Attorney (if applicable)
or
Name: . ................................................................................................................
Name . ........................................... Tel . ...................................
Address: ..............................................................................................................
..................................................................... Tel: . .............................................
Living Will
Details of GP:
I (full name) ................................................................................
Name: . ................................................................................................................
Of (full address) .........................................................................
Address: ..............................................................................................................
....................................................................................................
..................................................................... Tel: . .............................................
NHS No: .....................................................................................
Signature:................................................... Date:...........................................
have made this advance decision of my own free will, when of
sound mind, after careful consideration.
Witnessed by
I have discussed this decision with a healthcare professional
and am aware of the implications of my wishes.
Name: . ................................................................................................................
Address: ..............................................................................................................
..................................................................... Tel: . .............................................
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Patients Association
PO Box 935 Harrow Middlesex HA1 3YJ
Helpline: 0845 6084455
Admin: 020 8423 9111
www.patients-association.com
Registered charity no. 1006722
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