Please click here to log in with you RCPsych web account details; you will be redirected back to CPD Online.If you have forgotten your College web account details, you will be able to reset them here.
Please click here to log in if your institution has a subscription to CPD Online with Athens access.
Please click here to log in if you are subscribed through Medicom Netherlands.
If you having troubles signing in with the options above, please try this alternative login route.
by Dr Lisa Williams and
Dr John Rigby
Last updated: July 2016
'Advance directives' or 'living wills' were
originally designed for terminally ill patients. They are now seen
as increasingly relevant to psychiatry, where self-determination
has been recognised as a fundamental ethical principle.
Following the implementation of the Mental Capacity Act 2005,
there are two sorts of advance decisions – advance statements and
Advance Decisions to Refuse Treatment (ADRTs).
These anticipate a time when the capacity to make a treatment
decision has been lost, and detail a person’s wishes for future
medical treatment. As such, they are a way of enhancing patient
autonomy and choice.
As advance treatment refusals become more commonplace in
clinical practice, psychiatrists may well be called upon to give an
opinion about a person’s capacity to make an ADRT or be presented
with one by a patient. Thus, they need to feel confident in this
Start the module
If you like this module, you may also be
capacity and decision-making ability in mental
disorder by Dr Justine
McCulloch and Dr Mark
Dementia: capacity, empowerment and conflicts of
interest by Prof Cornelius Katona and Dr Gill Livingston
Irish Mental Health Act 2001 by Dr Larkin Feeney and Dr Brendan
Psychiatric aspects of terminal care
by Dr John Mitchell
Download take-home notes to print and
This module will:
NB: This module covers advance decisions in
England and Wales only. For Ireland, please see the
module Advance directives in
Advance statements and the law in Scotland will
also be published soon.