Making a living will in the UK means creating an Advance Decision to Refuse Treatment (ADRT), a written document that records your decision to refuse specific medical treatments in specific future circumstances, if you ever lose the capacity to decide for yourself. Under the Mental Capacity Act 2005, a valid ADRT is legally binding on healthcare professionals. Anyone aged 18 or over with mental capacity can make one, and it must clearly name the treatments you’re refusing and when.

Putting a living will in place can feel like a heavy subject, but the process itself is far more straightforward than most people expect. Below, we walk you through exactly how it works, what the law requires, and how to make sure your wishes are respected when it matters most.

What exactly is a living will?

A living will is a way of recording, in advance, the medical treatments you would want to refuse if you later became unable to communicate, for example, after a serious accident or illness. In UK law, it’s formally called an Advance Decision to Refuse Treatment, or ADRT.

It isn’t a general expression of preference. It’s a formal decision to refuse one or more specific treatments if a defined set of circumstances arises. For example, you might document that you refuse ventilation if you are in a persistent vegetative state, or that you decline resuscitation following a terminal diagnosis.

The name tells you what it does: it lets you make a decision to refuse treatment ahead of time. It doesn’t let you demand particular treatments, and it has nothing to do with your money or property; it speaks directly to clinicians about your care decisions. Think of it as your voice speaking for you at a moment when you can’t speak for yourself.

Is a living will legally binding in the UK?

Yes. This is one of the most common questions we’re asked, and the answer is reassuring: an advance decision is legally binding when it’s valid and it applies to the situation that arises.

The legal foundation is the Mental Capacity Act 2005, which governs how decisions are made for people who lack capacity in England and Wales. As long as your living will complies with the Mental Capacity Act, a healthcare professional is legally required to follow it.

For an advance decision to be legally valid and enforceable, several conditions must be met:

• The person making it is aged 18 or over and has capacity at the time.
• It names the specific medical treatments being refused.
• It states the circumstances in which the refusal applies so it’s clear when the decision to refuse treatment takes effect.
• It has not been withdrawn, verbally or in writing, since it was made.
• The person has not since created a Lasting Power of Attorney giving someone authority over the same decisions.

If any of these fall down, the ADRT may not be legally binding, and clinicians won’t be obliged to follow it. This is precisely why specificity in drafting matters. (Note: the rules differ in Scotland and Northern Ireland, so where you live matters.)

Who can make a living will?

The requirements are simple. You can make a living will if you are aged 18 or over and have the mental capacity to make the decision at the time you create it.

Under the Mental Capacity Act 2005, mental capacity means being able to understand, retain, weigh, and communicate the relevant information needed to reach a decision. You don’t need to be ill or elderly. Many people create one after a serious diagnosis, but it’s equally sensible to prepare one while you’re in good health precisely because capacity can be lost unexpectedly through accident or sudden illness.

The legal requirement is that you have capacity at the moment of signing, not at any point afterwards. That’s why it’s a good idea to act sooner rather than later. If capacity is ever disputed, the Court of Protection can become involved exactly the uncertainty a well-drafted living will helps you avoid.

How do you make a living will, step by step?

Here’s the process we guide our clients through when making a living will.

1. Consider your wishes carefully. Reflect on the specific circumstances in which you’d want to refuse treatment. It’s worth discussing your thinking with your GP or a specialist, particularly if you have a current diagnosis.
2. Draft the document with precision. Vague statements like “I don’t want to be kept alive artificially” aren’t enough. You must name the medical treatments you’re refusing and the precise circumstances in which the refusal applies to the situation. Generic templates downloaded without review often turn out too broad, too vague, or non-compliant.
3. Follow the special rule for life-sustaining treatment (see the next section).
4. Sign and have it witnessed where required, then keep the original safe.
5. Share copies with the right people so the document can be found when it’s needed.
6. Review it regularly as your health and wishes change.

We’ll expand on the most important of these below.

What are the rules for refusing life-sustaining treatment?

There’s one crucial exception. If your living will includes a decision to refuse treatment that is life-sustaining, meaning any treatment a clinician considers necessary to keep you alive, the Mental Capacity Act 2005 sets stricter conditions.

To validly refuse life-sustaining treatment, your ADRT must:

• Be in writing.
• Be signed and witnessed; the witness must be present when you sign, and must also sign.
• Include an explicit statement that the refusal applies even if your life is at risk.

That final line is essential. Without a clear acknowledgement that you understand your life is at risk, a refusal of life-sustaining treatment won’t be legally effective, no matter how carefully you’ve written the rest.

For treatments that aren’t life-sustaining, a living will can technically be verbal, but we strongly recommend putting everything in writing, signed and dated. A written document is far easier for a healthcare team to trust and act on.

Do you need a solicitor to make a living will?

Legally, no. There’s no requirement to instruct a solicitor or will-writing service to create a valid ADRT. But “allowed to do it yourself” and “wise to do it yourself” aren’t the same thing.

The entire value of a living will rests on it being valid, specific, and impossible to misread in a crisis, and that’s surprisingly easy to get wrong. A document that fails on precision or formalities may be set aside by clinicians who can’t be sure it genuinely reflects your wishes.

Professional guidance helps you:

• Word your refusals precisely, so they clearly apply to the situation.
• Observe the correct formalities, especially for life-sustaining treatment.
• Reduce the risk of your wishes being challenged or ignored.
• Consider whether a living will alone is right, or whether a power of attorney or both together would better reflect your intentions.

This is exactly where our team adds real value. You can learn more on our Living Wills service page, and see how it fits your wider plans on our wills overview.

How is a living will different from an advance statement or power of attorney?

These three tools are often confused, but they do very different jobs.

An advance statement is a helpful companion to a living will; it captures the softer preferences (where you’d like to be cared for, routines that matter to you) that a legal refusal can’t cover. It isn’t binding, but your care team should still consider it.

A power of attorney doesn’t state your wishes; it appoints a person. A Health and Welfare Lasting Power of Attorney lets someone you trust make care decisions, including consenting to or refusing treatment, if you lose capacity. One important nuance: if you create a Health and Welfare LPA after your ADRT, and it grants your attorney authority over the same decisions, the LPA will generally take precedence unless you’ve expressly stated otherwise. 

Timing matters, so these documents should be coordinated. Our guide on whether a living will differs from a Lasting Power of Attorney explains this further, and you can read about setting one up on our Lasting Power of Attorney page.

What happens if you’re diagnosed with a condition after making a living will?

Being diagnosed with a condition after you’ve made your ADRT doesn’t automatically invalidate it. But it’s important to review the document promptly to confirm it still reflects your wishes in light of the new diagnosis.

You should also notify your GP, so the updated position is reflected in your medical record and clinicians treating you are aware the document exists. Where a condition is progressive such as dementia or a neurological illness, it’s especially important to review and, if necessary, update your ADRT while you still have capacity. Once capacity is lost, the document can no longer be amended.

How do you keep your living will valid over time?

A living will isn’t a “write once and forget” document. To keep it effective, we generally recommend reviewing it regularly- at least every five years, or sooner if something changes.

Prompt a review when:

• Your health or medical history changes.
• You receive a new diagnosis.
• Your personal wishes shift.
• You create or update a Lasting Power of Attorney.

Accessibility matters as much as validity. A perfect document is useless if no one can find it in an emergency. Provide a copy to your GP for your medical record, share one with any hospital or specialist involved in your care, give one to a trusted family member or next of kin, and keep the original somewhere those close to you know to look. An ADRT can be withdrawn at any time, as long as you have capacity when doing so.

Making a Living Will: The Key Points at a Glance

• A living will is legally an Advance Decision to Refuse Treatment (ADRT) and covers medical treatments only, never your assets.
• Because it complies with the Mental Capacity Act 2005, a valid ADRT is legally binding on healthcare professionals.
• Anyone 18 or over with mental capacity can make one.
• Refusals must be specific, naming the treatment and the circumstances.
• To refuse life-sustaining treatment, it must be in writing, signed and witnessed, and state that it applies even if your life is at risk.
• An advance statement records preferences but is not binding; a later Lasting Power of Attorney may supersede your ADRT.
• No solicitor is legally required, but professional guidance helps ensure it’s valid and won’t be challenged.
• Keep it accessible (GP, family, next of kin) and review it regularly.

Speak to Our Living Wills Team

If you’re thinking about making a living will and want to be sure it’s done properly, we’re always happy to talk it through clearly, patiently, and with no pressure. Our Living Wills service is designed to make the whole process feel simple and to give you confidence that your wishes will be respected when it matters most.

Your legacy is too important to leave to chance, and planning it shouldn’t feel like climbing a mountain. Paradigm Wills makes the process of protecting your loved ones and securing your estate genuinely straightforward, with friendly, no-obligation consultations designed to put you at ease from the very first conversation. Whether you’re in Leicester, London, Birmingham, or anywhere in between, expert guidance is closer than you think. Take the first step today: call the Leicester Office on 0116 464 7055 or the London Office on 0208 194 7189.