A living will lets you refuse specific medical treatments in advance, in case a time comes when you can't make or communicate that decision yourself. That might be after a stroke, during a serious illness, or as dementia progresses. The document speaks for you when you can't. It covers your care while you are alive; your ordinary will deals with money and belongings after you die.
The short version
- In England and Wales, a living will that is valid and applies to the proposed treatment is legally binding. In Northern Ireland, a valid advance refusal is recognised under common law. Scotland has no equivalent law, but doctors must take your past wishes into account, and a clear living will is strong evidence of them.
- You can make one without a solicitor. The charity Compassion in Dying offers free forms, an online tool and a free helpline on 0800 999 2434. An online form still needs to be printed and signed.
- In England and Wales, refusing treatment that could keep you alive must be in writing, signed, witnessed, and include a statement that it applies even if your life is at risk. Following the same steps is sensible in Scotland and Northern Ireland too.
- It can only be followed if it can be found. Give your GP a copy, check it has been added to your record, and tell someone you trust where the original is kept.
What a living will can do
A living will lets you refuse almost any medical treatment, in circumstances you describe. Common examples include:
- cardiopulmonary resuscitation (CPR) if your heart or breathing stops
- a ventilator to help you breathe
- artificial nutrition and hydration, such as a feeding tube
- antibiotics for a life-threatening infection
- kidney dialysis
- a particular medicine or operation
Capacity is judged one decision at a time. A diagnosis of dementia, a stroke or difficulty speaking doesn't on its own mean you can't decide about a particular treatment. Your living will only comes into play for a decision you can't make yourself at the time.
There are limits on what it can do. A living will can't:
- Demand a treatment. You can refuse in advance, but doctors still decide what is clinically appropriate to offer.
- Refuse basic comfort care in advance. A living will can't require carers to withhold warmth, washing, the offer of food or drink by mouth, or measures aimed solely at relieving pain or distress. Food and fluids given through a tube or drip are medical treatment, and you can refuse them in a living will. If you can still decide for yourself at the time, you can turn down anything you are offered, including food and drink.
- Ask for anything against the law, such as help to end your life. The NHS draws a clear line here: refusing a treatment is a different thing from asking someone to end your life.
Living will, advance decision or advance statement?
"Living will" is the name most people use. In England and Wales the legal term is an advance decision to refuse treatment, often shortened to ADRT. In Scotland you will usually hear "advance directive". They describe the same kind of document, and this guide uses "living will" and "advance decision" to mean the same thing.
An advance decision and an advance statement are easy to confuse, and many people make both.
An advance decision (living will) refuses specific treatments in specific situations. In England, Wales and Northern Ireland, doctors must follow a valid one that applies to the situation in front of them.
An advance statement records your wishes, values and preferences more generally. You might write that you would rather be cared for at home, that comfort matters more to you than living as long as possible, or that you would like your faith respected and particular music playing. Anyone making decisions for you should consider it when working out what is best for you, though it doesn't bind them the way an advance decision does. (Here, "advance statement" means a general statement of care wishes. Scotland also has a separate legal kind of advance statement about mental health treatment, covered below.)
The advance statement gives the people caring for you a picture of who you are. The advance decision settles the specific refusals you feel sure about. Compassion in Dying has separate forms for each.
Is a living will legally binding?
It depends where you live. The rules differ between England and Wales, Scotland, and Northern Ireland.
England and Wales
The Mental Capacity Act 2005, sections 24 to 26, sets out the rules. You must be 18 or over, and you must have had the mental capacity to make the decision when you made it. If your living will is valid and applicable, doctors must follow it, even if they think the treatment would be in your best interests.
It is valid as long as:
- you haven't withdrawn it
- you haven't done anything since that is clearly inconsistent with it
- you haven't later made a health and welfare lasting power of attorney that gives your attorney authority over the same treatment (more on this below)
It is applicable when:
- you lack the capacity to make the decision yourself at the time
- it covers the treatment being proposed
- the circumstances match the ones you described
- there is no reason to think something has happened that you didn't anticipate and that would have changed your mind
If you are refusing life-sustaining treatment, meaning treatment that a clinician considers necessary to keep you alive, the law adds extra requirements. Whether a treatment counts depends on the situation: antibiotics can be life-sustaining in one illness and not in another. Your living will must be:
- in writing
- signed by you, or by someone else in your presence and at your direction
- signed in front of a witness
- signed by the witness in your presence
- clear that your decision applies "even if my life is at risk"
Miss any of these and doctors can't treat it as a binding refusal of life-sustaining treatment. It may still be evidence of your wishes when they decide what is in your best interests. A refusal of other treatment can technically be made out loud, but writing it down makes it far more likely to be followed.
Different rules can apply if you are detained under mental health law and the treatment is for a mental health condition. If that is relevant to you, take specialist advice.
Scotland
Scotland has no law that sets out advance decisions in the way the Mental Capacity Act does. The Adults with Incapacity (Scotland) Act 2000 requires anyone making decisions for an adult who lacks capacity to take account of that person's past and present wishes, and a living will is the clearest record of those wishes you can leave.
The Mental Welfare Commission for Scotland updated its guidance on this in July 2026. It says an advance directive may provide "compelling evidence" of a person's wishes. It isn't automatically binding, though a clear one may have legal effect in some circumstances. How much weight it carries depends on things like whether you had capacity when you made it, whether you made it freely, how clear it is, and whether the situation matches the one you described.
Scotland sets no legal formalities for an advance directive. Making it as clear and specific as you would in England, putting it in writing, signing it and having it witnessed are sensible precautions, especially if you are refusing life-sustaining treatment. Compassion in Dying also supports people in Scotland.
Scotland also has the welfare power of attorney, which lets you appoint someone to make health and welfare decisions for you. It is registered with the Office of the Public Guardian (Scotland). Many people make both.
Advance statements about mental health treatment are a separate thing in Scotland, with their own legal footing under the Mental Health (Care and Treatment) (Scotland) Act 2003.
Northern Ireland
In Northern Ireland, living wills rest on common law, the law built up through court decisions. A valid advance decision that applies to the situation has the same legal standing as a decision you make at the time, so doctors must follow it.
The Mental Capacity Act (Northern Ireland) 2016 is only partly in force. The parts covering research, money and valuables, and deprivation of liberty have started. The parts that would let you appoint an attorney for health and welfare decisions have not. An Enduring Power of Attorney in Northern Ireland covers financial matters only.
For now, that makes a living will the main way to make your treatment wishes count in Northern Ireland. Common law sets no required form, so even a spoken refusal can count. For anything serious, following the England and Wales steps is a sensible precaution: write it down, be specific, and have it signed and witnessed if you are refusing life-sustaining treatment.
Living will or lasting power of attorney?
The two do different jobs, and they work well together.
A living will records decisions you have made yourself about particular treatments. A health and welfare lasting power of attorney (in England and Wales) names someone you trust to make decisions for you, including ones you couldn't have predicted. Many people use both: the living will for the things they feel certain about, and an attorney for everything else. Compassion in Dying points out that a living will can also help your attorney show doctors what you would have wanted.
The order you make them in matters
In England and Wales:
- Living will first, LPA later. If the later LPA gives your attorney authority over the same treatment, your living will stops being valid for that treatment. Your attorney decides instead.
- LPA first, living will later. Your living will takes priority for the treatments it covers, and your attorney must follow it.
- Life-sustaining treatment. Your attorney can only refuse it on your behalf if your LPA expressly gives them that power. The LPA form asks you to choose.
If you have both, read them side by side and make sure they say the same thing. Tell your attorney what is in your living will. Our guide to setting up a lasting power of attorney covers the LPA itself, and the GOV.UK walkthrough shows where the life-sustaining treatment choice sits in the online form.
In Scotland the equivalent is a welfare power of attorney. In Northern Ireland, health and welfare attorneys are not yet available.
Before you write it
Most of the work happens before you pick up a pen.
Think about the situations that worry you. A severe stroke, advanced dementia, a condition you already live with, being kept alive on machines with no prospect of recovery. Start with what you can picture.
Think about what you would refuse in each one. Be specific. "No heroic measures" or "don't keep me alive on machines" sounds clear, but a doctor at 3am can't be sure what it covers. A more specific refusal names the treatment and describes the situation. As an illustration to talk through with your GP, rather than wording to copy: "If I have advanced dementia and can no longer recognise my family, I refuse antibiotics for a life-threatening infection. I understand this may shorten my life. This decision applies even if my life is at risk." A clinician can help you describe the situation precisely enough for doctors to recognise it.
Talk to your GP or specialist. They can explain what each treatment involves, what the likely outcomes are, and help you word it so it applies when it matters. A GP doesn't need to sign it.
Talk to the people close to you. A living will can be hard for a family to read for the first time in a hospital corridor. A conversation now spares them that, and means they can speak up for you with confidence.
If you are helping someone with a terminal illness or dementia put this in place, you may be grieving already, before any death. Our evidence-based guide on grieving before a death covers what the research shows and what helps.
How to make a living will, step by step
Step 1: Choose a form, or start from a blank page
There is no required format. Compassion in Dying offers a free online tool and a paper form, both written to meet the legal requirements in England and Wales. You can also use your own words.
Step 2: Write it down
Include:
- your full name, date of birth and address
- your GP's name and practice
- each treatment you are refusing, and the circumstances in which the refusal applies
- for any life-sustaining treatment, the words "even if my life is at risk"
- the date
Step 3: Sign it and have it witnessed
Sign it in front of a witness, who then signs it in your presence. For refusals of life-sustaining treatment in England and Wales this is required (see "Is a living will legally binding?" above). Everywhere else it is a sensible precaution. The Mental Capacity Act doesn't say who can be a witness. Choose someone who could later confirm that they saw you sign.
Step 4: Share it
Copies to your GP and the people close to you, and a note of where the original is kept. The next section covers this in detail, because it is where living wills most often fail.
Step 5: Review it
Look at it again when your health changes, and every couple of years anyway. See "Reviewing, changing or cancelling it" below.
Where to keep it, so it's found in time
A living will can only be followed if the people treating you know it exists and can see it. One left in a drawer that nobody knows about protects no one.
- Keep the signed original at home, somewhere safe that the people close to you know about. Our guide on where to keep a will and important documents covers the options.
- Give your GP a copy and ask for it to be added to your medical record. A few weeks later, check with the surgery that it has actually been added. Compassion in Dying suggests the same.
- Give a copy to your hospital team if you are under specialist care, and take one with you if you go into hospital.
- Give copies to your attorney, if you have one, and to the people closest to you.
- Carry a note in your bag or wallet saying you have a living will and where it is kept.
- Ask your GP about local care records. Some areas have shared electronic care plans that ambulance crews and out-of-hours teams can see.
Keeping it in AfterLoss
If you use Planning Mode, you can keep your living will alongside the rest of your plan:
- Important papers: upload a copy and choose the Health & Care category.
- Whereabouts: under Documents, choose Living will and note where the signed original is kept.
- Team: people you invite to your Team can see your documents at any time, including now, while you are well. If you are in hospital, they can find your living will without waiting for anyone. People listed in Contacts can't see your plan, so invite anyone who needs access from Team.
All three are in the Case tools menu.
Naming someone as your successor doesn't give them access while you are alive. A successor receives the plan after your death is recorded. If they might need to find your living will during an illness or a hospital stay, invite them to your Team as well, and check they can open it.
Keep giving your GP a copy too. Storing a copy in AfterLoss doesn't put it on your medical record, and it doesn't reach hospital or ambulance teams on its own.
Reviewing, changing or cancelling it
You can withdraw your living will at any time while you have capacity. In England and Wales, a withdrawal doesn't have to be in writing, but putting it in writing and telling everyone who has a copy avoids confusion later.
Look at it again:
- when your health changes, or you get a new diagnosis
- when your feelings about a treatment change
- before you make a lasting power of attorney, so the two fit together
- every couple of years, even if nothing has changed
The clearest way to change it is to write a new one, date and sign it (with a witness if it covers life-sustaining treatment), and send it to everyone who had the old one. Ask your GP and anyone else holding a copy to remove the old version or mark it as replaced. Destroying your own copy doesn't recall the ones already out there.
If you don't have a living will
If you can't make a particular treatment decision and have no living will that applies, the decision is made under the rules where you are being treated. It may fall to a clinician, or to an attorney or guardian with authority over that decision.
- England and Wales: a registered health and welfare attorney with authority for that decision can decide. Otherwise clinicians make a "best interests" decision under the Mental Capacity Act, taking your wishes into account.
- Scotland: the Adults with Incapacity (Scotland) Act 2000 has its own principles, including that any decision must benefit you and take account of your past and present wishes. A welfare attorney or guardian with the relevant powers may be involved.
- Northern Ireland: treatment decisions still largely follow common law, with clinicians acting in your best interests.
Being described as next of kin doesn't, on its own, give anyone the power to make your treatment decisions. What the people close to you know about your wishes still matters, and doctors will usually ask them. A clear living will that people can find gives your wishes the best chance of guiding your treatment, and where it is legally binding, of being followed.
DNACPR and ReSPECT forms
You may come across two other forms. A DNACPR (do not attempt cardiopulmonary resuscitation) form records a clinical recommendation about CPR alone. A ReSPECT plan records broader recommendations for your care in an emergency, informed where possible by conversations with you, or with people who know your wishes if you can't take part.
Neither form is itself a legally binding refusal. A living will is your own decision, and you can use it to refuse CPR yourself. Our guide to end-of-life planning explains DNACPR and ReSPECT in more detail.
What it costs
Making a living will yourself costs nothing. Compassion in Dying's forms and online tool are free, and their helpline (0800 999 2434) can talk you through it.
Some solicitors will draft one for a fee, which varies. It is optional, and a carefully written living will you make yourself has the same legal standing. A solicitor can be worth it if your medical situation is complicated, or if you are making a living will alongside an LPA and a will and want them checked together. Ask for a fixed fee before you start.
Jurisdiction checklist
England and Wales
- Legally binding if valid and applicable (Mental Capacity Act 2005, sections 24 to 26)
- Refusing life-sustaining treatment: in writing, signed, witnessed, with "even if my life is at risk"
- A later health and welfare LPA covering the same treatment overrides it
Scotland
- No equivalent statutory scheme; clinicians must take account of your past and present wishes under the Adults with Incapacity (Scotland) Act 2000
- A clear advance directive can be compelling evidence of your wishes and may have legal effect in some circumstances
- No legal formalities, but writing, signing and witnessing are sensible precautions
- A welfare power of attorney can cover health decisions
Northern Ireland
- Binding at common law if valid and applicable
- No required form, but the England and Wales formalities are a sensible precaution for serious refusals
- Mental Capacity Act (Northern Ireland) 2016 only partly in force
- No health and welfare attorneys yet; Enduring Powers of Attorney cover financial matters only