A Living Will and a Health and Welfare Lasting Power of Attorney both help you plan for a future time when you may be unable to make or communicate a decision about your health. However, they do different jobs.
A Living Will records your own decision to refuse particular medical treatment in specified circumstances. A Health and Welfare LPA appoints one or more trusted people to make a wider range of health and care decisions for you.
The right choice is not always one document or the other. Depending on your wishes, making both can provide clearer and more flexible protection—but they must be prepared carefully so that they work together.
What Is a Living Will?
“Living Will” is the familiar name for an advance decision to refuse treatment, sometimes shortened to ADRT.
It allows an adult with mental capacity to decide in advance that particular medical treatment must not be given if, at some future time, they lack the capacity to make that decision themselves.
For example, an advance decision might refuse a specified form of treatment if the person develops advanced dementia, suffers a severe brain injury or enters another clearly described medical condition.
If the advance decision is valid and applies to the treatment and circumstances in question, healthcare professionals must follow it. It has the same effect as a refusal made by a person who currently has capacity.
A Living Will can only refuse treatment. It cannot:
- Require a doctor to provide a particular treatment;
- Require treatment which is not clinically appropriate;
- Decide where you should live or how you should be cared for;
- Appoint another person to make decisions for you; or
- Ask anyone to do something unlawful.
While you retain capacity, you continue to make your own decisions. The advance decision only becomes relevant when you lack capacity to decide about the treatment at the time it is proposed.
The NHS guide to advance decisions provides further general information.
What Is a Health and Welfare LPA?
A Health and Welfare Lasting Power of Attorney is a legal document by which you—the donor—appoint one or more trusted people as your attorneys.
If you later lack capacity to make a particular decision, your attorneys may make health and welfare decisions on your behalf. These can include decisions about:
- Medical examinations and treatment;
- Care and support at home;
- Moving into residential or nursing care;
- Where you should live;
- Your diet, clothing and daily routine;
- Contact with other people; and
- Other aspects of your personal welfare.
A Health and Welfare LPA must be registered with the Office of the Public Guardian before it can be used. Unlike a Property and Financial Affairs LPA, it does not allow attorneys to act simply because the donor wants assistance: attorneys can only make a particular health or welfare decision when the donor lacks capacity to make that decision.
The donor can give guidance and place lawful restrictions in the LPA. Attorneys must follow the Mental Capacity Act 2005, consider the donor’s wishes and values, and act in the donor’s best interests. They cannot simply choose what they personally prefer.
The current Office of the Public Guardian guide to making an LPA explains the two types of LPA and how they are registered.
Living Will and Health and Welfare LPA: The Main Differences
| Question | Living Will | Health and Welfare LPA |
|---|---|---|
| Who makes the decision? | You make a refusal in advance. | Your chosen attorneys decide for you. |
| What does it cover? | Refusal of specified medical treatment in specified circumstances. | A broad range of health, care and personal-welfare decisions. |
| Can it consent to treatment? | No. It only refuses treatment. | Attorneys can usually consent to or refuse treatment within their authority. |
| Can it cover life-sustaining treatment? | Yes, if the special legal requirements are met. | Yes, but only if the LPA expressly gives attorneys that authority. |
| Can it cover care or accommodation? | No. | Yes. |
| When does it operate? | When you lack capacity and the refusal is valid and applicable to the proposed treatment. | When you lack capacity to make the particular health or welfare decision. |
| Must it be registered? | No. | Yes, with the Office of the Public Guardian. |
| Can it respond to an unexpected situation? | Only if the wording covers the treatment and circumstances. | Attorneys can respond flexibly within the authority given. |
Can a Living Will Refuse Life-Sustaining Treatment?
Yes, but additional legal safeguards apply.
An advance decision refusing life-sustaining treatment must:
- Be in writing;
- Be signed by the person making it, or by someone signing at their direction;
- Be witnessed; and
- State clearly that the refusal applies even if life is at risk.
The treatment and the circumstances in which it is to be refused must also be described sufficiently clearly. A vague statement may not apply when a decision is needed.
Life-sustaining treatment is not limited to resuscitation. Depending on the medical circumstances, it may include ventilation, antibiotics, artificial nutrition and hydration, or other treatment needed to sustain life.
Discussing the proposed wording with a GP or relevant specialist can help ensure that medical terms and possible future circumstances are understood accurately.
Can Attorneys Decide About Life-Sustaining Treatment?
Only if the donor expressly gives them that authority in the Health and Welfare LPA.
The LPA form requires the donor to choose whether attorneys may give or refuse consent to life-sustaining treatment, or whether those decisions should remain with the healthcare professionals responsible for the donor’s treatment.
Even where attorneys have authority, they cannot insist on treatment that clinicians do not consider clinically appropriate. They must make decisions within the LPA and in the donor’s best interests.
Which Document Takes Priority?
This depends upon the documents, their dates and the authority they confer.
An advance decision may cease to be valid, to the relevant extent, if the person later creates a Health and Welfare LPA giving an attorney authority to decide about the same treatment. Conversely, a later valid and applicable advance decision may restrict what an attorney can decide.
Conflicting wording can cause uncertainty at exactly the time when a clear decision is needed. In a serious disagreement, the Court of Protection may have to decide whether an advance decision is valid and applicable or whether an attorney has authority.
Anyone making both documents should therefore:
- Tell the person preparing each document about the other.
- Use consistent language about treatment and life-sustaining decisions.
- Make the intended relationship between the documents clear.
- Give copies to the attorneys, GP and relevant healthcare providers.
- Review both documents after any major change in health, treatment preferences or personal circumstances.
Is an Advance Statement the Same as a Living Will?
No. An advance statement records wishes, feelings, beliefs and preferences about future care. It might describe:
- Where you would prefer to be cared for;
- Religious or cultural beliefs;
- Dietary needs;
- People you would like to be consulted;
- Personal routines and things that comfort you; or
- General wishes about care and treatment.
An advance statement is not legally binding in the same way as a valid and applicable advance decision. However, it should be considered when someone is deciding what is in your best interests.
An advance care plan may bring together an advance statement, a Living Will, information about an LPA and other practical care wishes.
Should You Make a Living Will, an LPA or Both?
A Living Will may be particularly helpful if you have firm views that you would not want a specified treatment in clearly defined circumstances. It places your own refusal at the centre of the decision.
A Health and Welfare LPA may be more suitable where you want people who know you well to respond flexibly to circumstances that cannot be predicted in advance. It also covers many decisions that a Living Will cannot address, including care, residence and daily welfare.
Making both may be appropriate if you want to record definite treatment refusals while also appointing attorneys to deal with other health and welfare questions. The documents should be drafted as a coordinated plan rather than prepared independently.
Neither document replaces a Will dealing with property after death, nor a Property and Financial Affairs LPA dealing with money and assets during life.
You can read more about why an LPA can be useful at any adult age and the current LPA registration fees, exemptions and reductions.
Frequently Asked Questions
Is a Living Will legally binding?
Yes, if it is valid and applies to the particular treatment and circumstances. If there is genuine doubt, healthcare professionals may provide treatment while the position is clarified, and an application to the Court of Protection may sometimes be required.
Can my family override my Living Will?
Family members do not have a general right to override a valid and applicable advance decision. They may provide information about your wishes or question whether the document is valid or applies to the circumstances, but the legal test must still be followed.
Does my spouse automatically make medical decisions for me?
No. A spouse, civil partner, partner or adult child does not automatically become a health and welfare attorney. Without a valid LPA, they may be consulted but do not acquire the legal authority conferred by an LPA.
Can I change my mind?
Yes, while you have capacity. You can withdraw or replace an advance decision and can revoke or replace an LPA, provided the legal requirements are followed. Tell everyone holding an earlier copy and recover or mark obsolete copies to reduce the risk of confusion.
Do I need both types of LPA?
A Health and Welfare LPA does not authorise attorneys to manage bank accounts, bills or property. Those matters require a separate Property and Financial Affairs LPA. You can make one type or both.
Planning Your Future Health and Care Decisions
Do It Legally provides a careful, personal service for Living Wills, advance care planning and Lasting Powers of Attorney in Brighton & Hove and remotely.
We can help you understand the different documents, record your wishes clearly and ensure that documents prepared together are consistent. Our current Living Will service and LPA service details are available on the Do It Legally website.
Contact Do It Legally to discuss which arrangements best reflect your wishes.
Information checked on 14 September 2026. This article provides general information about the law of England and Wales and does not constitute advice on any individual circumstances. Medical choices should also be discussed with an appropriate healthcare professional.