Advanced decision to refuse treatment


A very important part of MND care is ensuring that the patient feels in control of what happens to them at all stages. An ADRT can be used to make those wishes clear to those who care for you.

What is an Advance Decision to Refuse Treatment?

An Advance Decision to Refuse Treatment (ADRT) is a decision you can make in advance, to refuse specific treatments under certain circumstances in the future. This can include the right to refuse life sustaining treatment.

Before making an ADRT (sometimes also called an Advance Directive) you should discuss the contents with your doctor or another member of the care team to ensure that you are clear regarding which treatments you wish to decline and that you have a full understanding of the possibility of discomfort and putting your life at risk.

For example, if you use Non-invasive Ventilation (NIV) your ADRT might cover any circumstances in which you wish the NIV to be withdrawn. An ADRT is legally binding and replaces documents which used to be known as a ‘living will’. It only becomes valid once you lose the ability to make or communicate those decisions.

Who needs to know about my ADRT?

If you have made an ADRT you need to ensure relevant members of your health and social care team and your family and carers are aware of its contents. It is helpful to keep a list of everyone that has a copy. You may wish to inform your local ambulance service. Sometimes people decide to wear a bracelet or carry a card informing people that they have an ADRT and listing who has a copy.

If you wish to discuss making an ADRT in more detail, please contact the Care Centre Coordinator.

Further information, advice and resources regarding end of life decisions can be found on the Dying Matters website.