You will need an Advance Health Directive when the unexpected happens and you are not able to make any decisions about your future health care. For example, when you are involved in a serious car accident, as a result, you are in a coma.

You will also need an Advance Health Directive if your lifelong illness has worsened and removed your ability to make decisions.

This document allows you to set out

• what medical treatment you want or
• don’t want to receive

This document must also be completed with your doctor and witnessed by an authorized witness (solicitor, JP).

You must:

• be at least 18 years old
• have the capacity to understand the document you are signing and the powers it gives
• be able to make your advance health directive freely and voluntarily
• not be pressured into making it by someone else

The Advance Health Directive will come into effect once you (the principal) do not have the capacity to make your own healthcare decisions.

It can cover your directions on:

• life-sustaining treatment
• other health care
• blood transfusions (Consent to, or refuse a blood transfusion)

Generally speaking you have 4 options:

1. Consent to all treatments aimed at sustaining or prolonging your life.
2. Refuse any treatments aimed at sustaining or prolonging your life.
3. You cannot decide at this point. You want your attorney(s) to make decisions using the information in this advance health directive and in consultation with your health providers and the people you have listed.
4. Give specific directions about life-sustaining treatments.

Yes, you can. However, your wishes to withhold or withdraw from life sustaining measures can only be respected if one of the following occurs:

• Terminal illness or incurable/irreversible condition
• Persistent vegetative state
• Permanent unconsciousness
• Irrecoverable illness or injury
• You have no reasonable prospect of regaining capacity for health matters.

You can do the following:

• For each of your health conditions, specify treatment and medication
• Specify your preference with special procedures such as (sterilisation, termination of pregnancy, participation in special medical research or experimental health care)

It is highly recommended that you review your advance health directive:

• every two years or
• if your circumstances change (marriage, health changes, etc)

Yes, you may revoke or cancel your advance health directive at any time you have the capacity to do so.

You do not need to complete a specific form to cancel or revoke your advance health directive. However, the revocation or cancellation must be in writing and you must take all reasonable steps to advise all people involved.

Your advance health directive may be revoked when you:

• make a later advance health directive
• die
• have set terms in your advance health directive to ensure for its revocation
• get married or enter into a civil partnership
• get divorced or your civil partnership is terminated

Your advance health directive may also be revoked, if the attorney or attorneys:

• die
• resign
• does not have the capacity for the matter for which they have been appointed
• become your paid carer
• become your health provider
• become a service provider for a residential service where you reside.

Unlike an Enduring Power of Attorney, an Advance Health Directive only talks about your health.

Furthermore, the Advance Health Directive is a reflection of your decision. Whereas, Enduring Power of Attorney allows your appointed Attorney to make decisions for you in the future.

When you create the Advance Health Directive, you are called the “principal”.

You can use your advance health directive to appoint someone you trust to make decisions about your health care on your behalf.

This person is called your ‘attorney’ and you can appoint more than one if you choose.

They don’t need any legal experience to carry out this role.

To be an attorney in your advance health directive, a person must:

• be 18 years or older
• have capacity to make healthcare decisions
• not be your paid carer or your health provider
• not be a service provider for a residential service where you live

In terms of your advance health directive, there are many obligations for your attorney, some important ones include:

• Your attorney can only make decisions about your health care when you do not have the capacity to make decisions about health care yourself
• Your attorney must only make decisions that follow your advance health directive
• Your attorney must respect your views, wishes and preferences

Yes, a doctor is needed to complete and sign a specific section of your Advance Health Directive.

It is highly recommended that you speak to your general or specialist medical practitioner who is familiar with your medical history and current treatments.

The doctor must be able to state that you are not suffering from depression or any other condition that would affect your understanding of the directions in the Advance Health Directive.

In addition, the doctor must be able to record your instructions and more importantly, to correctly describe medical treatment instructions.

1. Think about your wishes and preference for your future medical treatments.
2. Discuss these views with your family, friends.
3. Discuss with your regular doctor.
4. Consider who you will appoint as your decision maker and substitute(s).
5. Reach out to Ascent Lawyers!