Say what medical care you would refuse, before a crisis decides for you.
An advance care directive, living will, advance care plan, medical directive, or health care instruction records what matters to you if you cannot speak for yourself. Different places use different names. The heart of it is the same: your wishes as life comes toward its end.
This is about death.It is also about pain relief, dignity, family conflict, avoiding treatments you would never have wanted, and giving doctors a clear direction when everyone is frightened.
Dementia and brain injury
The elephant in the room is losing capacity before you can speak.
Dementia, stroke, trauma, infection, lack of oxygen, and other neurological illness can leave a person unable to make or update a plan. That is when relatives, attorneys, doctors, hospitals, and care facilities may argue about what the person “would have wanted.”
Use this site to write your wishes in plain words. Then take the draft to your usual doctor and, where possible, a lawyer or official witness in your home jurisdiction. Many places have government forms that must be used for a binding document.
Write the outcome you would accept. For example: “I would accept hospital treatment if I am likely to return home and recognise my family.”
Name the outcome you would not accept. For example: “I do not want to survive on a breathing machine with severe brain damage.”
Choose a decision-maker. Pick the person who will actually follow your wishes, not the person who will find it easiest emotionally.
Discuss it with your GP or treating specialist. Ask what the treatments mean for your actual illness.
Make it valid locally. Laws differ between countries and even between states. Signing, witnessing, capacity checks, medical power of attorney, and family authority rules vary.
Put it where doctors can find it. Give copies to your decision-maker, GP, hospital, aged-care facility, lawyer, and emergency record such as ANONAMED.
Treatment limits
Questions worth answering before the emergency
These are not commands to tick casually. They are prompts for a serious conversation with your doctor and the person who may speak for you.
Resuscitation
Full resuscitation: try every reasonable option, whatever it takes.
No attempt to restart my heart or breathing.
CPR trial only if the team believes recovery is realistic.
About 10 minutes of CPR only, unless there is a clear reversible cause.
Up to 3 or 4 defibrillator shocks only, then stop if no useful response.
No CPR chest compressions.
No defibrillation shocks.
Even full resuscitation cannot guarantee survival or recovery. Longer CPR often means lower chance of meaningful survival and higher risk of brain injury, especially when collapse is unwitnessed or illness is advanced.
Breathing support
No breathing tube through the mouth or neck.
No artificial airway devices.
No CPAP, BiPAP, or high-flow oxygen mask if it only prolongs dying.
No breathing machine or ventilator.
No intensive care unit.
No extra oxygen, unless it is for comfort.
Hospital treatments
No dialysis machine to clean my blood.
No antibiotics for serious infection.
No heart medicines to force the heart to work harder.
No adrenaline, epinephrine, or blood-pressure drugs.
No insulin, if I am dying and it is not for comfort.
No blood transfusions or blood products.
Food, fluid, tests, procedures
No drip fluids into a vein.
No liquid nutrition into a vein.
No feeding tube through the nose, stomach, or abdomen.
No investigations, blood tests, scans, or monitoring.
No procedures or surgery.
Keep me comfortable and allow me to die peacefully.
Difficult choices
Pain, peace, and refusing everything
Some people want every possible treatment. Some want comfort medicines only. Some refuse all medicines for religious, philosophical, or personal reasons. That can be a valid choice, but it should be made with eyes open: refusing all medication can mean refusing pain relief, anxiety relief, breathlessness relief, and sedation for unbearable distress.
A good directive can be direct: “I understand this may shorten my life” or “I understand this may mean more suffering, but this is my wish.” It can also say the opposite: “Do not leave me in pain to preserve a few more days.”
Printable forms
Draft your wishes, then make them legal where you live
These generic forms are useful conversation documents. Your local government forms or lawyer-prepared document may be required for legal force.
Advance care directive draft
Generic draft only. Confirm local legal requirements, signing, witnessing, and decision-maker appointment rules.
Brain injury, permanent disability, and nursing-home care
If resuscitation or life support is likely to leave me with severe permanent brain damage, severe permanent disability, or permanent nursing-home level care that I would not have accepted, these are my instructions:
Restarting heart or breathing
Breathing
Medicines
Fluids, feeding, blood
Tests and procedures
Comfort and place
Dementia, brain disease, stroke, trauma, infection, or loss of mental capacity
Once I lose mental capacity, I may no longer be able to make or update an advance care plan. I want these instructions to be considered as my current settled wishes if I later lose capacity suddenly or slowly, including from dementia, neurological disease, stroke, brain injury, trauma, infection, or another cause.
I understand that after loss of capacity I may depend on relatives, a power of attorney, guardians, doctors, hospitals, or care facilities to act in good faith. I am recording these wishes now so they are not ignored because I can no longer argue for myself.
Advance care directive notice
I have written advance care wishes. Please contact my decision-maker and usual doctor before non-urgent treatment decisions if I cannot speak for myself.
Find help
Doctor, lawyer, government forms
Most people should start with their GP, then use the official forms or a lawyer to make the document valid locally.
Law
Not the same as euthanasia or voluntary assisted dying
An advance care directive usually refuses or limits medical treatment. Voluntary assisted dying is a separate legal pathway where a person asks for medical help to die. Rules differ widely: eligibility, residency, prognosis, doctors, waiting periods, reporting, and whether clinicians may raise the topic vary by place.
This site is about advance care planning and refusing or limiting unwanted treatment. It does not provide voluntary assisted dying guidance. Get current local medical and legal advice if that is relevant to you.
