An advance statement and an advance decision to refuse treatment (ADRT) are two types of advance care planning documents that are used in the UK. Both documents are intended to articulate a person’s preferences and wishes for future medical treatment, but they are different in their scope and legal status.

Firstly, an advance statement is a formal, written statement that sets out a person’s preferences in regards to their future care, but it does not make any specific decisions about any types of treatment. It can cover any aspect of a person’s physical, mental, and spiritual well-being that isn’t directly medically related.

For example, an advance statement might cover preferences for care location (such as wanting to be cared for at home, rather than in hospital), dietary requirements, and beliefs or values that may need to be taken into consideration when providing care. While healthcare professionals should consider the advance statement when making decisions, they are not legally bound by the contents of an advance statement.

On the other hand, an advance decision to refuse treatment (ADRT) is a legally binding document that outlines the specific circumstances under which a person would not want certain treatments or types of care. This document is often used to refuse treatments that could potentially prolong life, such as ventilator support or resuscitation efforts.

For example, an ADRT might include clauses stating that the individual does not wish to receive certain treatments if they were in a permanent vegetative state, or in the advanced stages of a terminal illness. Importantly, an ADRT only comes into effect when a person lacks the mental capacity to make or communicate their own decisions.

In essence, while an advance statement focuses on preferences for care and is not legally binding, an ADRT outlines specific medical treatments to refuse and is legally binding when the individual cannot make decisions for themselves. Both forms play a crucial role for people in maintaining autonomy over their future healthcare.

Given that we’ve established the differences between an advance statement and an advance decision to refuse treatment (ADRT), it’s natural to move onto questions about how one might create these documents, whether they are legally binding, and what happens if circumstances change.

Q1: How are advance statements and ADRTs created?
An advance statement is not a legally binding document and there is no specific form it has to take. It can be written by anyone and can include anything that is important to the individual, such as their values and beliefs or preferred foods and routines. It can be written by the person themselves or typed by another person on their behalf. At myADRT, we offer an easy and quick way to create this document online where you can fill in, register, and download the ADRT form for safekeeping and sharing.

Adversely, an ADRT is a legally binding document in the UK as long as it complies with certain conditions. It must be written by a person who has the mental capacity to make such decisions, stating clearly which treatments the person would like to refuse should they lose the mental capacity in the future. It must be signed by the person and witnessed by another individual. The document must also specify that the refusal of treatment applies even if the person’s life is at risk.

Q2: Are advance statements and ADRTs legally binding?
Advance statements are not legally binding in the UK. However, they must be taken into consideration by healthcare professionals when making decisions about a person’s care and treatment.

On the other hand, as long as the specific requirements are met, an ADRT is legally binding. This means that health professionals must follow the individual’s decisions about refusing certain treatments. Failure to do so may lead to legal consequences.

Q3: What happens if I change my mind?
Both advance statements and ADRTs can be altered or completely revoked at any point as long as the individual possesses the mental capacity to do so. To effectively change or revoke an ADRT or advance statement, it would be sensible to destroy the old version and create a new one. Any distribution to healthcare professionals or loved ones should be revoked, and the new document should then be redistributed.

Q4: What if my ADRT and advance statement contradict each other?
An ADRT that is valid and applicable takes precedent over an advance statement. In a situation where they contradict each other, medical professionals will follow the decisions outlined in the ADRT. It is important therefore, to ensure both documents are kept up to date and echo your current wishes, to avoid any confusion or conflicts.

If you are considering creating an ADRT or updating an existing one, we encourage you to register your ADRT form with myADRT by visiting https://myadrt.com/register/  By registering with myADRT, you can ensure that your document is created, stored, and shared more efficiently with healthcare professionals and trusted individuals involved in your care.

Additionally, please consider sharing the myADRT service with your friends, family, or loved ones who may also benefit from having an ADRT in place. By spreading the word about this valuable service, you can help others take control of their future medical care and ensure their wishes are respected even when they are unable to communicate them personally. Registering an ADRT with myADRT is a proactive step towards peace of mind for both you and the people who care about you.