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by Dr Lisa Williams and
Dr John Rigby
Last updated: October 2018
'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
This module will:
Start the module
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