| 释义 |
advance decision
A legally recognized decision (often described as a living will) regulated by the Mental Capacity Act 2005, in which a mentally capable adult identifies specified treatment (e.g. a blood transfusion) that should not be carried out in the event that he or she loses capacity. Generally, there is no requirement that the decision be in writing unless it relates to life-saving treatment (in which case it must be in writing and witnessed by a third party). In order to be effective the directive must be valid (e.g. the patient must not have withdrawn it or done anything inconsistent with the decision: HE v A Hospital NHS Trust [2003] EWHC 1017 (Fam), [2003] FLR 408). It must also be applicable to the treatment in question. There is an additional requirement under the 2005 Act s 25(4), namely that the advance decision will not apply if there are reasonable grounds for believing that circumstances exist that the patient did not anticipate at the time of the decision, and that these would have affected his decision, had he anticipated them. For example, the patient’s advance decision might be challenged if at the time he made the decision he did not realize all the treatment options now available for the condition that has arisen. In particular, the focus here has been on modern advances in pain relief. Whether the advance decision stands frequently depends on how carefully it was drafted (X Primary Care Trust v XB [2012] EWHC 1390 (Fam.)). A medical professional who provides treatment in contravention of an advance directive that he or she knows to be valid and applicable is potentially committing a tortious or criminal act. |