Offering advice about and putting together Advance Decisions provides a holistic service. It ensures your clients are fully informed about the options available, which is particularly useful if they have strong preferences for their future care.

Advance Decisions (often referred to as “Living Wills”) retail for roughly £100-£150 and can be used to allow individuals to record their treatment preferences should they lose the capacity to make decisions themselves.

There are four different types of Advance Decision, which are available to draft in Arken Professional. Using software to build key estate planning documents provides an efficient drafting experience that ensures all key documents are stored sensibly together.

General Advance Decision

A General Advance Decision provides broad instructions to refuse specific treatments in the future. It allows clients to outline treatments they do not wish to receive, regardless of the medical condition or circumstances in which they might find themselves incapacitated.

This is suitable for individuals who have clear objections to specific types of treatments, such as life-sustaining interventions or blood transfusions, but do not wish to elaborate on specific medical scenarios or conditions.

Real-life example

A client who is a Jehovah’s Witness may use a General Advance Decision to refuse all blood transfusions under any circumstances.

Advance Decision Defining an Intolerable Condition

An Advance Decision Defining an Intolerable Condition is more specific, outlining the medical conditions or scenarios a person deems intolerable and specifying the treatments they refuse in those situations.

This is suitable for clients who want to refuse treatment only if certain conditions arise that they believe would significantly diminish their quality of life. This type of Advance Decision enables a person to focus on the context of their health rather than outright refusal of treatment.

Real-life example

A client might state that they refuse artificial ventilation if they are permanently unconscious or in a persistent vegetative state. Similarly, they might define a condition such as advanced dementia as intolerable and specify that they would not want resuscitation or feeding tubes in such circumstances.

Advance Decision Requesting Maximum Treatment

An Advance Decision Requesting Maximum Treatment is less common but equally important. It is used to assert a preference for receiving all possible life-sustaining treatments, even in situations where the prognosis is poor or quality of life may be severely diminished.

This is suitable for clients who wish to ensure that every effort is made to prolong their life, regardless of the circumstances. It can be used to counteract presumptions about a preference for non-intervention.

Real-life example

A client may express that they want all available treatments, including resuscitation, ventilation, and advanced therapies, even if they are diagnosed with a terminal illness or are in a critical condition with low chances of recovery.

Advance Decision Defining Treatment Preferences

An Advance Decision Defining Treatment Preferences outlines treatments the individual would prefer to receive under certain circumstances. While Advance Decisions are typically associated with refusals of treatment, this type can also act as a guide for healthcare professionals regarding an individual’s wishes in scenarios where specific treatments are desired.

This is suitable for clients who want to ensure that certain treatments are prioritised in particular scenarios. While it cannot compel healthcare professionals to provide treatment, it gives clear guidance on the person’s preferences.

Real life example

A client may indicate that they would prefer palliative care measures, such as strong pain relief and sedation, in terminal illness scenarios. Alternatively, they might request specific interventions, like hydration or antibiotics, in certain conditions, even if they refuse other life-sustaining treatments.

Arken Top Tips:

1. Encourage your client to discuss their Advance Decision with their GP or other medical professionals to ensure their wishes are clear and achievable.
2. Use Comentis in Arken Professional to run a digital mental capacity test to help ensure your client is of sound mind whilst making these important decisions.
3. Set a reminder with your client to review their Advance Decision as time goes on, ensuring they remain happy with their current preferences.
4. Arken allows you to specify that an Advance Decision remains valid alongside an LPA, ensuring both documents work seamlessly together.

How to Draft in Arken Professional

Take this product tour to find out how to draft an Advance Decision in Arken Professional and see just how simple and easy it is.