# Advance decision to refuse treatment (England and Wales)

Source: https://onco.cc/terms/advance-decision-to-refuse-treatment/  
OnCo record `advance-decision-to-refuse-treatment` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In England and Wales, an adult can write down in advance which treatments they refuse if they later cannot decide. To refuse treatment that keeps you alive, it must be in writing, signed, witnessed and say it applies even if your life is at risk.

## Summary

Section 24 of the Mental Capacity Act 2005 defines an advance decision as a decision made by a person aged 18 or over, while they have capacity, that if a specified treatment is later proposed at a time when they lack capacity to consent, it is not to be carried out or continued. It may be expressed in layman's terms and may be withdrawn or altered at any time while the person has capacity.

Section 25(5) and (6) set the extra conditions for refusing life-sustaining treatment: the decision must be verified by a statement that it applies even if life is at risk, and the decision and statement must be in writing, signed by the person (or by another in their presence and at their direction), and signed or acknowledged in the presence of a witness who also signs. A later health and welfare lasting power of attorney covering the same treatment can override an earlier advance decision; section 25 sets out when.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: advance decision; ADRT; living will (England and Wales)
- Tags: supportive; uk

## Sources

- Mental Capacity Act 2005, section 24 (legislation.gov.uk): https://www.legislation.gov.uk/ukpga/2005/9/section/24
- Mental Capacity Act 2005, section 25 (legislation.gov.uk): https://www.legislation.gov.uk/ukpga/2005/9/section/25

## Connected records

- terms: [Advance care planning](https://onco.cc/terms/advance-care-planning/), [Lasting power of attorney for health and welfare (England and Wales)](https://onco.cc/terms/lasting-power-of-attorney-health-welfare/)

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