My Living Will - Neuro-degenerative disease - refuse treatment at end stage illness

about my living will

share this page

Advance Decision at late stage of disease

You may wish for active intervention if you are in coma or a minimally conscious state.

Below are scenarios which you might like to consider. If you would like withdrawal or refusal of treatment in any or all of these situations, select the relevant options for the decisions to be added to your Advance Decision.

When your Advance Decision would apply

In each clinical situation described below, the opinion of two senior specialist doctors will decide that you show no signs of significant improvement meaning that you would return to virtually the same mental function as prior to the event. If this is the case, your Advance Decision will come into effect.

If you are suffering from a neuro-degenerative disease, and are coming to the end of your life, you may wish withdrawal of any of these treatments.
This will apply if you are in coma or a minimally conscious state or have lost the ability to make decisions about your health.

If you are on any form of life-support (e.g. assisted ventilation, artificial feeding or hydration) this should be withdrawn.

You recognise that withdrawal of the above treatments would mean you would die. You wish to have every other treatment e.g. pain relief and / or sedation to keep you comfortable.

Category:

Neuro-degenerative conditions

Decision

You can't alter this text. If you wish to select then click Add to Current Document

If I am on any form of life-support (e.g. assisted ventilation, artificial feeding or hydration), I wish the life support to be withdrawn.

If you are unable to swallow liquids or solids. In this circumstance:

You can decide not to have any form of fluids or nutrition - by mouth or tube. Refusing to be fed will shorten your life.
You wish to be kept comfortable and have every treatment to keep you comfortable to ensure you do not suffer pain or discomfort. This could include having a small amount of fluid given under the skin that will help keep you comfortable or being sedated.

Category:

Neuro-degenerative conditions

Decision

You can't alter this text. If you wish to select then click Add to Current Document

If I am unable to swallow liquids or solids, I do not want to have any form of fluids or nutrition by mouth or by tube.

If you are in coma or in a minimally conscious state or have lost the ability to make decisions about your health and you require life support including mechanical ventilation. In this circumstance:

You may wish to refuse life support or have it removed. This includes:

If you are having difficulty breathing then you do not wish for artificial respiration that requires a tube in your throat.
If you are having difficulty breathing then you do not wish for a pressure mask to be placed over your nose and mouth.
If your general condition deteriorates so that drugs are required to keep you alive, then you do not wish to receive such drugs.
If you are unable to eat or drink, then you do not wish to have any fluids or nutrition via tubes.

You understand that such removal of life support will cause your life to end.
You wish to be kept comfortable and have every treatment to keep you comfortable, for example being sedated, to ensure you do not suffer pain or discomfort.

Category:

Neuro-degenerative conditions

Decision

You can't alter this text. If you wish to select then click Add to Current Document

I wish to refuse life support or have it removed. This includes:

If I am having difficulty breathing then I do not wish for artificial respiration that requires a tube in my throat.
If I am having difficulty breathing then I do not wish for a pressure mask to be placed over my nose and mouth.
If my general condition deteriorates so that drugs are required to keep me alive, then I do not wish to receive such drugs.
If I am unable to eat or drink, then I do not wish to have any fluids or nutrition via tubes.

You may get a severe infection that, if not treated(with or without artificial ventilation) could result in your death. The most common life threatening infection is a lung infection (pneumonia). In this circumstance:

You can decide you do not want any treatment that may keep you alive. Refusing treatment for a serious infection may shorten your life.
You wish to be kept comfortable and have every treatment to keep you comfortable, for example being sedated, to ensure you do not suffer pain or discomfort.

Category:

Neuro-degenerative conditions

Decision

You can't alter this text. If you wish to select then click Add to Current Document

If I get a severe infection that, if not treated (with or without artificial ventilation), then I do not want any treatment that may keep me alive.

Final steps

To save your Advance Decision, select the 'Download' option under 'Document Builder'. You will then need to:

Print off your Advance Decision.
Sign and date your Advance Decision in the presence of a witness.
Get your Advance Decision signed and dated by your witness.

The same steps apply to your Advance Statement, if you have created one.

What to do after creating your Advance Decision

Informing family and / or close friends as well as you GP will ensure that the treatments you wish to refuse are known. This is the only way of making sure that your Advance Decision can be followed should you lose the ability to make decisions.

You should now therefore:

Make many copies of your signed and witnessed Advance Decision.
Inform your GP about your Advance Decision, especially if you have not already consulted them about creating one.
Tell members of your family and people who help look after you about your Advance Decision and what you have written in it.
Give your GP, family and / or close friends signed and witnessed copies of your Advance Decision, and your Advance Statement if you have created one.
Make sure that is is recorded in your medical notes that you have an Advance Decision and / or Advance Statement.

Document Builder

Advance Statement