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18th February 2016

Making a Statement

A new website has been launched by the charity Compassion in Dying to make it easier for people to write down what they want for them to happen in the event of needing treatment. What the website is doing is nothing new, this means of determining what should happen to you in the future if you are no longer able to make decisions yourself is enshrined in the Mental Capacity Act 2005, to be precise in section 24. What the website does is generate an online form that you can complete, print, and have witnessed to ensure greater clarity if your choices about treatment are ever needed. The website address is

Reading about this new website made me think it would be useful to remind ourselves about the law of making decisions in advance. I’ve written something about the issues before in previous blogs In your best interest only and Advance decisions, planning ahead.

Crucial distinction

So just a reminder about a crucial distinction between two terms, advance decisions and advance statements. Advance decisions are decisions you make now, whilst you have the mental capacity to do so, to refuse treatment in the future even if you need it, even if you need it to stay alive. You have the right in law now to state your wishes and they must be respected by doctors. How would anyone know you’d made them? That’s the advantaged of something like the My Decisions website. It is recorded properly, and it encourages you to share your decision with others who need to know (like your GP or your family).

Just a couple of other pieces of terminology you might have come across, one is living will, that essentially is the same as an advance decision and the other term is advance directive. This is a more old-fashioned term used before the Mental Capacity Act 2005 came in. For the avoidance of doubt the current legal term is advance decision.

Making choices

The other term which I mentioned at the beginning of the article is called advance statement, but these are not legally binding. These are usually about decisions that aren’t life or death, but about a range of issues such as dietary requirements, where you would want to live, financial arrangements, choices about treatment (not whether you get it or not but what type of treatment you would prefer). Again the issue of how would anyone know you had made these is important, and the My Decision website allows you to record these as well. What’s the point if they’re not legally binding? Well they are a useful way of letting wishes and desires be known if at some point in the future you lack capacity to make day to day decisions. Section 4 of the Mental Capacity Act says that any decisions made on your behalf should be in your best interest, and the guidance to the Act says that your wishes should be taken into account in arriving at a best interest decision. The advance statement is a great way to ensuring these wishes are not forgotten.

David Beckingham – QCS Expert  Mental Health  Contributor

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