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Written by Mitch Tapner.
12 minute read
Thinking about future medical care can feel difficult, especially when it involves conversations about illness, loss of independence, or the end of life. But for many people, putting their wishes in writing brings reassurance and helps loved ones feel more confident about the decisions they may one day face.
Despite the name, a living will is completely separate from your financial will. A financial will explains what happens to your money and possessions after death. A living will focuses on the medical treatments you would or would not want while you are still alive.
In this guide, we’ll explain what a living will is in the UK, how an Advance Decision to Refuse Treatment (ADRT) works, when it becomes legally binding, and how it can support advance care planning alongside a Lasting Power of Attorney (LPA).
Key takeaways:
We understand that discussing end-of-life plans with your family may not always feel easy, but it can provide peace of mind once it’s done. Our guide is here to offer you helpful advice on how to talk to your loved ones about direct cremation in a simple, clear way.
For tips on how to make these conversations easier, click the link below to download our guide.
These terms are often used interchangeably, which can make things confusing. They all relate to planning ahead for future care and can form an important part of end-of-life planning, but they each mean something slightly different.
‘Living will’ is the term many people search for online. It does not have a formal legal definition in UK law, but most people looking for a living will in the UK are actually referring to an Advance Decision to Refuse Treatment.
An ADRT is the official legal document recognised under the Mental Capacity Act 2005 in England and Wales. It allows you to refuse certain medical treatments in advance if you lose mental capacity in the future.
If your ADRT is valid and applies to the situation, healthcare professionals must follow it by law.
An advance statement is different. It records your wishes, beliefs, values, and preferences about future care.
For example, you might include:
An advance statement is not legally binding, but healthcare professionals should still take it into account when making decisions about your care.
You may also see the term ‘advance directive’. This is more commonly used in the United States. In England and Wales, the correct legal term is ADRT.
An advance care plan is a broader plan for future care. It may include:
Many people create advance care plans with support from their GP or care team.
Scotland uses slightly different laws and terminology. You may hear the phrase ‘advance directive’ under the Adults with Incapacity (Scotland) Act 2000. If you live in Scotland, the Office of the Public Guardian Scotland can offer guidance.
An ADRT allows you to refuse specific medical treatments in clearly defined situations.
For example, you can refuse:
You can also explain the circumstances where those refusals apply. For example, you may state that you refuse ventilation if you are permanently unconscious or in the later stages of advanced dementia.
What an ADRT cannot do is just as important.
It cannot:
This matters because a living will is not about giving up. It is about helping ensure your wishes are understood if you cannot speak for yourself.
Many people confuse an ADRT with a Do Not Resuscitate Order (DNR), but they are different documents.
A DNR is a medical decision about whether CPR should be attempted if your heart or breathing stops. It is agreed with your healthcare team and recorded by a doctor. You cannot create a DNR yourself without medical involvement.
You can, however, include a refusal of CPR within your ADRT. If this is something you are thinking about, it can help to talk it through with your GP or healthcare team.
Yes. An ADRT is legally binding in England and Wales if it is made correctly under the Mental Capacity Act 2005.
For an ADRT to be valid, it must meet these requirements:
If the ADRT refuses life-sustaining treatment, there is one more important requirement.
It must clearly state that the refusal applies ‘even if life is at risk’.
Without this wording, healthcare professionals are not legally required to follow refusals of life-sustaining treatment.
You can change or cancel your ADRT at any time while you still have mental capacity. This can even be done verbally, although updating the written document and informing your GP is strongly recommended.
An ADRT can also become invalid automatically in some situations involving a Lasting Power of Attorney for health and welfare. This can catch people by surprise, which is why the next section is important.
An ADRT and a Lasting Power of Attorney (LPA) for health and welfare often work best together. But the order you create them in matters.
If you make an LPA after an ADRT, the LPA may override parts of the ADRT or make it invalid.
If you make an LPA before an ADRT, the LPA remains valid alongside the ADRT, but your attorney cannot override the specific refusals written into a valid ADRT.
In practical terms:
Many people find it helpful to have both documents. If you plan to create both, it is usually safest to make the LPA first and the ADRT afterwards.
If your circumstances are more complicated, legal advice may help.
Making an ADRT is often simpler than people expect.
Try to be clear and specific.
For example:
Statements such as “I don’t want to be kept alive artificially” may be too vague to be legally effective.
Compassion in Dying offers a free ADRT template and online service for people in England and Wales. Their helpline can also guide you through the process.
It is one of the most widely used and legally robust options available.
You must sign the document in front of a witness.
The witness must also sign it.
If your ADRT refuses life-sustaining treatment, make sure the wording confirms the refusal applies ‘even if life is at risk’.
An ADRT can only help if people know it exists.
Give copies to:
It also helps to let people know where the original document is stored.
Your wishes may change over time.
It can help to review your ADRT:
Using Compassion in Dying’s template and helpline is free.
An ADRT prepared by a solicitor will usually cost between £100 and £350 or more, depending on complexity. There is no official registration fee.
Many people can complete a straightforward ADRT in a single afternoon once they have thought through their wishes.
For an ADRT to be followed in an emergency, medical professionals need to know it exists and be able to access it quickly.
If you are unconscious in A&E, paramedics and doctors may not know you have an ADRT unless it has been shared properly.
To help make sure your wishes can be followed:
Keeping a photo on your phone may help, but on its own it is unlikely to be enough.
An ADRT can only be made while you still have mental capacity.
For someone with an early dementia diagnosis, making an ADRT sooner rather than later can be one of the most important decisions they make.
It gives you time to think calmly about treatments you may wish to refuse later, such as:
Being specific matters. Healthcare teams need clear instructions about the treatment and the circumstances where refusal applies.
It is also sensible to create a Lasting Power of Attorney for health and welfare at the same time. This gives someone you trust the authority to make decisions your ADRT may not directly cover.
For many families navigating dementia and end-of-life care, this kind of planning brings reassurance. It can remove the burden of trying to guess what their loved one would have wanted.
To understand more about later-stage dementia, see our guide to signs of end of life in dementia.
Without an ADRT, healthcare professionals make decisions based on what they believe is in your best interests.
Family members are often consulted, but they cannot legally refuse treatment on your behalf unless they hold a health and welfare LPA.
In emergencies, doctors usually default to preserving life. That may include:
Even if those choices may not reflect what you would have wanted.
For some families, making an ADRT also opens the door to talking about death and dying more openly, which can make difficult decisions feel a little less uncertain later on.
Making an ADRT does not cost anything if you use a free template, and many people can complete one in an afternoon. For some families, the peace of mind it brings can feel invaluable.
Making a living will is one of the most thoughtful things you can do for the people closest to you. It can bring clarity at a time that may otherwise feel emotionally difficult and uncertain.
For many families, knowing they are following your wishes brings comfort and reassurance. It can ease the pressure of making difficult decisions without guidance.
If you would like to talk through your end-of-life preferences, learn more about direct cremation or explore prepaid funeral plans, our Aura Angels are here whenever you feel ready. Call us free on 0800 808 5723.
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A financial will explains what happens to your money, property, and possessions after death. A living will, formally called an Advance Decision to Refuse Treatment, records which medical treatments you want to refuse while you are alive but unable to communicate.
Yes. A valid ADRT is legally binding under the Mental Capacity Act 2005 if it is written correctly, signed, witnessed, and includes the required wording for refusals of life-sustaining treatment.
Yes. Compassion in Dying provides a free ADRT template and free telephone support for people in England and Wales.
Yes. You can cancel or update an ADRT at any time while you still have mental capacity.
An ADRT is a legal document you create yourself. A DNACPR or DNR is a medical instruction agreed with your healthcare team and signed by a doctor.
No. Many people complete an ADRT using a free template. However, legal advice may help if your circumstances are more complex.