Yes, an Advance Decision to Refuse Treatment (ADRT) is legally binding in the UK. This means that if healthcare professionals know about it, they must respect it. There are, however, certain requirements that must be fulfilled if the ADRT is to be legally binding.

Firstly, the person making the ADRT (the ‘maker’) must be 18 or over, and have the mental capacity to make, understand and communicate decision about their treatment. This means they must understand the information relevant to the decisions they are making, be able to retain that information long enough to make a decision, be able to weigh up the options and communicate their decisions.

Secondly, the ADRT must clearly specify what treatments the maker wants to refuse and in what circumstances. This is to ensure that it’s clear under exactly what circumstances the refusal of treatment applies.

Thirdly, if the ADRT is about refusing life-sustaining treatment the standard for this is slightly higher. It must be in writing, signed by the maker (or someone else in the maker’s presence and by their direction) and the signature must be witnessed. The ADRT must also include a specific statement that the decision applies even if life is at risk.

For example, if someone were to make an ADRT refusing any form of resuscitation in the event of a cardiac arrest, this would have to be in writing, clearly specified, signed and witnessed, and accompanied by a statement that the decision applies even if their life is at risk.

Failure to meet any of the above requirements might result in the ADRT not being legally binding. It should also be noted that even when an ADRT is legally binding, healthcare professionals may decide not to follow it if they believe that the maker has done something that clearly goes against their ADRT, like changing their mind but not cancelling their ADRT.

It’s important that the maker keeps their ADRT under review and reconsider it if their situation changes. If they change their mind about their ADRT, they need to cancel it and make a new one, regardless of whether their old ADRT is legally binding or not.

Bear in mind that these are general points, and the specifics of making a legally binding ADRT may vary. therefore this cannot replace the advice of a solicitor or other legally qualified professionals.

An answer to the question “Is an ADRT legally binding?” might lead to several follow-up inquiries, such as:

1. “What are the conditions that make an ADRT legally binding in the UK?”
   Advance Decision to Refuse Treatment (ADRT) becomes legally binding in the UK when certain specified conditions are met. They must be clearly written, specifying which treatments the person does not wish to receive and under what circumstances. Additionally, it must be signed by the person making the ADRT and witnessed. If it includes a decision to refuse life-sustaining treatment, it must be in writing, signed, witnessed, and include a statement that it applies even if life is at risk. It’s essential to note that an ADRT is only appropriate if the person is currently unable to make or communicate their treatment decisions.
2. “Can an ADRT be changed or revoked, if yes, how?”
   An ADRT can be altered or revoked at any time as long as the person has mental capacity to do so. It is recommended to review the ADRT regularly and whenever there is a significant change in the person’s health condition. To make these changes, the person needs to clearly communicate or demonstrate their wishes, ideally in writing. Any changes should follow the same formalities as creating a new ADRT, such as being signed, witnessed, and addressing life-sustaining treatments if necessary.
3. “How does an ADRT interact with other forms of advance care planning, like Lasting Power of Attorney (LPA)?”
   If a person has created an LPA for health and welfare decisions, it is vital to coordinate these with any ADRT. If both exist, the one made most recently will usually take precedence. For example, if the ADRT is made after the LPA and the person still had capacity, the decisions in an ADRT would overrule any decisions made by the person given LPA. Conversely, if an LPA is appointed after an ADRT is made, the LPA would have the authority to refuse or consent to medical treatments on behalf of the person unless the ADRT explicitly states otherwise.
4. “What happens if medical professionals do not follow the wishes stated in the legally binding ADRT?”
   Healthcare professionals have a legal duty to respect a person’s valid and applicable ADRT. If they administer treatment that has been refused in a valid ADRT, they can be taken to court and liable for damages. However, it is crucial to make the ADRT known to medical professionals, by discussing it with them in advance where possible and having it easily accessible, for instance, by registering and storing it with a service such as myADRT at https://myadrt.com/.
5. “Is there any circumstance when an ADRT might not be followed, even if it meets all legal requirements?”
   There are a few instances where a healthcare professional might not follow an ADRT, even if it’s legally valid. These include: if they’re not aware of it, if the person’s circumstances have changed significantly since they made the ADRT (for example, advancements in medical treatments), or if the wording in the ADRT document is ambiguous or unclear. Therefore, it is crucial to ensure the ADRT is clear, up-to-date, and easily accessible to healthcare providers.

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.