Advance Directives
The following brief notes were made by Steve Bazire in April 2005, and were moderately up-to-date at the time. Additional updates and advice would be gratefully received.
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Advance Directive instructions cannot be ignored unless:
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They do not apply to that situation
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They are unclear
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the MHA comes into force
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Life is at risk
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Can only apply to treatments you do NOT want to have
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Do not have to be in writing, have witnesses, and can be changed
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Should be accessible eg in notes
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MHA trumps them
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Have no legal validity
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Need to be well distributed ie copies with the user, carer, advocate, notes
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Are time consuming to do (2-3hrs each), hard work, cover all available options, outcome unknown
It might also be worth a MedLine - in April 2005 there were half a dozen publications, although they didn't prove much. Google will also pull up lots.
Documents:
Norfolk and Waveney Mental Health Partnership NHS Trust template
Links:
Kent mental health services, including template
Bazelon Centre for mental health Law: Judge David Bazelon's US psychiatric advance directive forms, but they are over 20 pages long and cover everything in full US-style litigation-robust style
Advance directives - MIND information pages (good)
Institute of Psychiatry information on Joint Crisis plans and advance directives