In the United Kingdom, anyone can act as a witness to an Advance Decision to Refuse Treatment (ADRT), except the person who stands to benefit from the death of the person making the Advance Decision. It is essential to identify a suitable and qualified witness to provide an independent confirmation of the person’s identity and capacity to make an ADRT. It is also recommended that the witness has an understanding of the nature and the purpose of an ADRT.

In ADRT documents involving the refusal of life-sustaining treatment, the ADRT must be signed in the presence of a witness, who in turn must sign the document in the presence of the person making the decision. It is important as it provides an additional layer of safeguarding and validity to the decision made. Hence, a witness’s role is primarily to affirm that the person making the ADRT made it voluntarily without any influence.

The witness can be anyone from a person’s circle, such as their friends, neighbours, or colleagues – provided they meet the requirement of not standing to financially benefit from the individual’s death. However, it is generally advised that the witness should not be anyone related to your healthcare, such as your General Practitioner or healthcare provider. This is because they could potentially be involved in future treatment discussions, and thus to avoid any conflict of interest, it is advisable for it to be someone unrelated to your healthcare.

For instance, if Mr. Smith decides to create an ADRT, his friend John, with whom he has no financial relationships, could qualify as a witness. John would be there when Mr. Smith signs the document and John would sign it in Mr. Smith’s presence, affirming Mr. Smith’s willingness and mental capacity to make such a decision.

In summary, the choice of a witness for an ADRT is crucial, not only legally, but also ethically, to ensure that all decisions made are truly reflective of the individual’s wishes regarding their healthcare treatment.

People are likely to have additional questions after understanding who can witness an advance decision. Some of the immediate follow-up questions might include:

1. “Can a witness also be an appointed decision-maker?”
   It’s strongly advisable that a witness to an ADRT (Advance Decision to Refuse Treatment) should not be someone already appointed under a Lasting Power of Attorney (LPA) for Health and Welfare. This is to prevent any conflict of interest. A witness should be an impartial party. For example, if an appointed decision-maker witnesses the ADRT, they may be biased towards the patient’s preferences outlined in that ADRT when making decisions, which may not necessarily be in the patient’s best interest at the time of decision-making.
2. “What is the role of the witness in the process of making an ADRT?”
   The role of the witness is to confirm that the person making the advance decision – to refuse treatment is doing so voluntarily, without any form of coercion or influence from others. They also verify that, at the time of making the decision, the person had the mental capacity to understand, retain, and weigh the information relevant to their decision. It is not the role of the witness to make decisions on behalf of the person or to influence their decision in any way. The witness’s role is purely observational and confirmatory.
3. “What information should the witness provide on the ADRT form?”
   The witness should provide their full legal name, their signature, and the date they witnessed the person signing the document. It might also be helpful for them to provide their contact information, like an email or phone number, in case anyone needs to get in touch with them about the ADRT, although this is not strictly necessary.
4. “Can a family member be a witness to the ADRT?”
   Yes, a family member can be a witness to an ADRT, provided they are not a named decision-maker in another legal document such as a Lasting Power of Attorney for health and welfare. They must also not stand to gain or lose from the patient’s death. This is in order to prevent potential undue influence or bias.
5. “How many witnesses are required for an ADRT?”
   Under UK law, you only need one witness to an ADRT. However, having more than one can add extra assurance that the documentation has been correctly witnessed.
6. “How can someone witness an ADRT during the ongoing COVID-19 pandemic when social distancing is necessary?”
   During times when face-to-face contact is not advisable or possible, there are still options available for witnessing an ADRT. These include witnessing via video conferencing software, like Skype, Zoom or MS Teams. The witness can watch the person sign the document in real time, and then the document can be sent to the witness by post, who can then sign it and return it. They just need to be sure they can identify the person signing the ADRT and be confident that they are signing it of their own free will. Note that the law surrounding witnessing documents via video conference is evolving and it is always best to check the most recent guidance.

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.