Introduction

A Lasting Power of Attorney (LPA) for Health and Welfare is a legal document that lets you appoint people, known as 'attorneys', to make decisions on your behalf at a time when you are no longer able to make your own decisions.

Your 'attorneys' are under a duty to act in your best interests when making any decision under your LPA. You can give them the right to make specific decisions about what medical treatments you will or will not be given, as well as decisions about other aspects of your health and welfare.

The process of creating and registering your LPA has protections built into it to ensure that making the LPA is your choice and you are not being coerced.

Different types of LPA

There are two types of LPA:

• LPA for Health and Welfare  
  This deals with your healthcare and consent to medical treatment. If you want your attorney to be able to refuse life sustaining treatment on your behalf this must be specifically stated under this LPA.
• LPA for Property and Financial Affairs
  This deals with the administration of your property and finances.

Only information about the LPA for Health and Welfare is provided on this website. To find out more about both types of LPA, visit the GOV.UK website.

Relationship between an LPA for Health and Welfare and an Advance Decision

There is a well-defined relationship between an Advance Decision and an LPA for Health and Welfare. If you choose to make both an Advance Decision and an LPA for Health and Welfare, the order in which they are made is important:

• If you make an Advance Decision after making and registering an LPA for Health and Welfare, the Advance Decision is what must be followed. This means an 'attorney' cannot give consent for treatment that has been refused in an Advance Decision.
• If you make an Advance Decision before making and registering an LPA for Health and Welfare, which gives the 'attorney' the right to consent to or refuse treatment, then the Advance Decision ceases to be enforceable. As a result,  the 'attorney' can choose not to follow the Advance Decision once the LPA for Health and Welfare is registered. From this point the 'attorney' will make decisions on your behalf.
• If you have made the Advance Decision to Refuse Treatment (ADRT) first and then the LPA Health and Welfare, you can reconfirm your ADRT by a new signature and date after the date of the LPA.  This reaffirmation will thus revalidate your ADRT.

How to create and register an LPA for Health and Welfare

For the LPA for Health and Welfare to be legal, you need to complete the appropriate forms and then register your LPA with the 'Office of the Public Guardian'. As soon as it is accepted by doctors or health care professionals that you are no longer able to make your own decisions about your healthcare, your attorney will have authority to make such decisions on your behalf. It is the registration that makes the LPA legally enforceable, so you can complete the forms and register them at a later date or register them straight away.