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Advance decisions to refuse treatment

23 January 2013 - National End of Life Care Programme


This guide is designed to help health and social care professionals understand and implement the law relating to advance decisions to refuse treatment (ADRT) contained in the Mental Capacity Act (2005).

This 2013 version replaces that published in September 2008 and covers:

  • How to make an advance decision to refuse treatment, who can make an advance decision, when a decision should be reviewed and how it can changed or withdrawn
  • What should be included
  • Rules applying to advance decisions to refuse life sustaining treatment and how they relate to other rules about decision-making
  • How to decide on the existence, validity and applicability of advance decisions and what healthcare professionals should do if an advance decision is not valid or applicable
  • The implications for healthcare professionals of advance care decisions, including situations where a healthcare professional has a conscientious objection to stopping or providing life-sustaining treatment
  • What happens if there is a disagreement about an advance decision.