Living Wills (Advance Decisions) in the UK – What You Need to Know

May 8, 2026

A Living Will, legally known as an Advance Decision to Refuse Treatment (ADRT), is a document that lets you set out medical treatments you do not want to receive in the future, in case you become unable to make or communicate decisions.

It’s a powerful way to stay in control of your healthcare, especially in situations involving serious illness or life‑sustaining treatment.

1. What Is a Living Will?

A Living Will (ADRT) allows you to refuse specific medical treatments in advance. It only takes effect if you lose mental capacity to make the decision yourself, for example, due to an accident, stroke, dementia, or serious illness. If the ADRT meets the legal requirements, doctors must follow it. It is legally binding under sections 24-26 of the Mental Capacity Act 2005.

2. When Is a Living Will Legally Binding?

Your ADRT will be legally binding if the following requirements are met:

You were 18 or over and had mental capacity when you made it.
It clearly states which treatments you want to refuse.
It is valid, meaning you haven’t withdrawn it, contradicted it, or done anything that would make it unclear.
It applies to your circumstances; it must match the medical situation you are in.

If you want to refuse life‑sustaining treatment, such as ventilation or tube feeding:

The ADRT must be in writing,
It must be signed and witnessed,
It must state that the decision applies “even if my life is at risk.”

3. Why Should You Consider Making a Living Will?

A Living Will can help:

Make sure your wishes are respected, even if you can’t speak for yourself.
Prevent distress for your loved ones, who won’t need to make difficult decisions on your behalf.
Give clear guidance to doctors about what you do and do not want to have done to you if you are very ill.

However, recent cases show that Living Wills need to be clear, communicated, and accessible to avoid delays or disputes.

4. Recent Court Cases:

Re AB (2025) – A Disputed Living Will.

In Re AB (ADRT: Validity and Applicability) [2025] EWCOP 20 (T3) involved a man, AB, who had suffered severe brain damage and was kept alive through clinically assisted nutrition and hydration (CANH). He had previously signed a Living Will refusing such treatment if he developed a serious brain injury.

His family disputed on the following points:

Whether the document was genuine,
Whether he signed it freely,
Why it wasn’t shared with doctors earlier,

The court ruled that the ADRT was valid and applicable, even though questions about authenticity were postponed for later due to missing evidence. Importantly, the judge confirmed that doctors must not provide treatment that a person has lawfully refused in an ADRT.

Key lesson: Your Living Will must be stored somewhere accessible and shared with your GP, family, and anyone involved in your care. Delays can cause long and stressful legal disputes.

Case Study 2: Re AB (Disclosure): Transparency Issues

A follow‑up judgment dealt with whether documents from AB’s case should be shared with an observer to the court. Although this wasn’t directly about the refusal of treatment, it confirmed that:

AB’s ADRT was accepted as binding after the family withdrew their objections.
CANH could be lawfully withdrawn, as AB had expressed in his Living Will.
Key lesson: Courts will honour a valid ADRT, even where family members initially object.

5. Common Issues Highlighted by These Cases

Recent judgments show several common problems, namely:

5.1 Living Wills aren’t always shared.

In AB’s case, friends didn’t notify doctors about the ADRT for nearly four months, which caused major complications.

5.2 Family disagreements can lead to legal delays.

If your family isn’t aware of your wishes, they may challenge the document later.

5.3 Healthcare providers need clear instructions.

If a Living Will isn’t on your medical record or shown to clinicians promptly, important decisions may be made without knowing your preferences.

6. How to Make Your Living Will Effective.

To ensure your Living Will works when you need it, we recommend:

Make it clear and specific,
List treatments you wish to refuse and avoid vague wording.,
Share it widely with close friends and family members,
Give a copy to your GP.
Tell your solicitors.
Keep a copy at home in an obvious place where your friends and family can easily find it.
Consider carrying a card or wearing a bracelet stating that you have an ADRT.
Regularly review and update it if your health changes or if you change your mind.
Seek legal advice; we can help ensure the document is valid and aligns with your wishes.

Thinking About Making a Living Will?

We can guide you through the process, help you understand your options, and ensure your wishes are documented clearly and legally. A properly drafted and communicated ADRT can prevent confusion, avoid disputes, and give you peace of mind that your future medical decisions remain your decisions.

If you’d like us to prepare a Living Will for you or review an existing one, we’re here to help. Please contact us.

Graeme Black

Partner, Private Wealth & Inheritance

<script>
document.addEventListener('DOMContentLoaded', function () {
  const deptEl = document.getElementById('acf-author-department');
  const department = deptEl?.dataset?.department;

  if (typeof gtag === 'function' && department) {
    gtag('set', { author_department: department });
  }
});


  window.dataLayer = window.dataLayer || [];
  const dept = document.getElementById("author-department")?.textContent?.trim();
  if (dept) {
    window.dataLayer.push({
      event: "authorDataReady",
      author_department: dept
    });
  }

</script>

View profile Contact Us

Johan Mackay

View profile Contact Us

This reflects the law and market position at the date of publication and is written as a general guide. It does not contain definitive legal advice, which should be sought in relation to a specific matter.