An Advance Decision to Refuse Treatment (ADRT) is indeed legally binding in England and Wales, as stipulated by the Mental Capacity Act 2005. This means that medical professionals are bound to respect it, provided that it complies with certain conditions.

These conditions broadly relate to the clarity of the directions provided, the specificity of the circumstances, and the mental capacity of the person at the time the ADRT was made.

To illustrate, an ADRT may specify that the person does not wish to receive artificial ventilation under circumstances where they have a severe stroke and are unable to breathe without assistance. If the person had the mental capacity to understand the implications of this decision when they made it, the ADRT will usually be legally binding and doctors must respect it.

However, there are exceptions. For instance, if there’s reasonable belief that circumstances exist which the person did not anticipate at the time of the ADRT and would have influenced their decision, the ADRT may be held not binding. Also, if the designated treatment is not applicable to the current circumstances, the ADRT may not be observed.

It’s also worth noting that if the ADRT involves the refusal of life-sustaining treatment, it must be in writing, signed by the person (or by another person in their presence and at their direction), and witnessed. Also, it must include a specific statement that the advance decision is to apply even if life is at risk.

In Scotland and Northern Ireland, while there’s less statutory clarity, ADRTs are likely to be upheld by courts, based on common law principles of self-determination and the right to accept or decline medical treatment.

In light of the above, it is strongly recommended that those planning to create an ADRT do so with careful thought and ideally with professional advice, to ensure that their wishes are accurately recorded and will be legally binding. Services like myADRT can provide help and guidance in drafting and registering an ADRT.

Taking into consideration the previous question, likely follow-up queries could fall within the following lines:

1. “What conditions must an ADRT satisfy to be legally binding?”

Advanced Decision to Refuse Treatment (ADRT) becomes legally binding under the Mental Capacity Act of 2005 once specific conditions are met. Firstly, you must be 18 or over and possess the mental capacity to make, understand, and communicate your own decisions at the time of making your ADRT. This involves being fully aware of the implication of your decision and any potential consequences. Secondly, the ADRT must be clear about which treatments you are refusing and under what circumstances. Lastly, if the refusal is about lifesaving treatment, ADRT must be written, signed by you and a witness and should include the phrase ‘even if life is at risk as a result’.

2. “What would render an ADRT invalid or inapplicable?”

Despite being legal, your ADRT could be rendered invalid or inapplicable for several reasons. If there’s evidence that you’ve changed your mind since making the ADRT, it would be viewed as invalid. If you had made another later legal document (like a Lasting Power of Attorney) authorizing someone else to make decision about your treatment, the ADRT would be invalid. The ADRT may also not apply if the situation is not the one you had specifically described in the ADRT or if your medical condition is not the one specified in the ADRT. Finally, if there have been significant medical advancements that could impact your decision, the ADRT may not be applicable.

3. “Can an ADRT be updated or revoked?”

Yes, an ADRT can be updated or revoked at any time as long as you have the mental capacity to do so. You can change or cancel your ADRT verbally or in writing. However, it’s recommended to update it in writing, notify all relevant parties about the changes and destroy all copies of the old version to prevent any confusion in the future.

4. “How can I ensure that my ADRT is acted upon?”

To ensure that your ADRT is adhered to, it’s crucial that your healthcare team and loved ones are aware of its existence and where it’s stored. You could share it with your General Practitioner (GP), family members, and any caregivers or home helpers. You can even keep a note in your wallet indicating that you’ve an ADRT and where it can be found.

Please remember it’s essential to consult with healthcare professionals while making your ADRT so they can provide you with appropriate medical advice. This can help in making an informed decision and ensuring that the wording of your ADRT is clear and specific. The myADRT platform provides support in creating, registering and storing your ADRT.

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.