Increasing understanding and uptake of advance decisions in Wales

This report draws on an examination of the literature and consultation with stakeholders directly involved in advance decisions to refuse treatment (ADRT) to identify ways of increasing awareness and uptake of ADRTs in Wales. The report looks at the current legal position in England and Wales, the current update and effectiveness of advance treatment refusals, attitudes to advance decisions and the views of health and social care practitioners. Barriers to the uptake up of ADRTs identified, include: misunderstanding about what is involved; scepticism about whether the patient’s wishes will be respected; and the mistaken belief that an ADRT is unnecessary if someone has already informed family members or healthcare professionals of what they would want. The report recommends actions for the Welsh Government, charities and other organisations to ensure people understand their options for advance care planning and their right to refuse treatment, if they so wish. These include: an increase in public education; correcting official forms that may mislead people about the legal status of their own or a relative’s expressed wishes; facilitating access to well designed ADRT forms/guidance and skilled support; normalising ADRTs (e.g. offering registration when patients sign up with a GP); training relevant practitioners to ensure that they understand what ADRTs are (and when they are valid and applicable), are able to provide appropriate guidance or referral, and can act in accordance with the law concerning them.