An advanced directive or living will – It’s important to specify, especially lying flat. Good news if you take action.

There are many advantages to planning ahead. There is nothing more certain than death (and taxes) and it is best to plan ahead for a certainty. In the UK, although the official line is to encourage  Living Wills or Advanced Directives (ADs), (The Christie NHS Foundation Trust) very few people actually take the trouble to do one. Facing up to reality is as difficult for us all as individuals as it is for the Politicians running the Regional Health Services so dishonestly…

An AD is not a request for Euthanasia. Some of us think it sad that we cannot have the same humane end of life care as animals, but we seem to be a small minority at present.. The Royal College of  Vetinary Surgeons (RCVS) talks about “killing to relieve suffering” on its website.. There are arguments for and against Euthanasia

AD is particularly relevant where a cancer leads to unbearable pain and where the drugs needed to gain control of that pain make the patient virtually unconscious, or in advanced neurodegenerative diseases such as the dementias, MS or Motor Neurone Disease.

The shorter and simpler your AD the better. If you lie flat you will get “hypostatic pneumonia a type seen in the weak or elderly, due to excessive lying on the back” – would you like to go this way? My Own Advance Decision or Living Will – this file gives you some idea of the amendments I have made (italics) to the Christie NHS foundation trust template.


(The Christie NHS Foundation Trust)

The Patient’s Association, Patient UK, Wikipedia,

Fiona Haas in 2005 discusses living wills in The Nursing Times.

The Alzheimer’s Society discusses Advance decisions and advance statements and has their forms for download.


Debating Euthanasia (Debating Law): 3 by Emily Jackson and John Keown (2 Dec 2011)

Euthanasia: A Licence to Kill? by Anthony Smith (13 Apr 2006)

Causing Death and Saving Lives: The Moral Problems of Abortion, Infanticide, Suicide, Euthanasia, Capital Punishment… by Jonathan Glover (28 Jun 1990)

A Time to Live: The Case Against Euthanasia and Assisted Suicide by George Pitcher (23 Jul 2010)

Euthanasia and Assisted Suicide (vol. 217 Issues Series) by Lisa Firth (12 Sep 2011)

The Kindest Thing by Cath Staincliffe (27 May 2010)

Euthanasia, Ethics and Public Policy: An Argument Against Legalisation by John Keown (25 Apr 2002)

Windigo Soul by Robert Brumm (15 Feb 2014)

They Shoot Horses, Don’t They? (Serpent’s Tail Classics) by Horace McCoy

Should there be a reward for registering an AD? Deserts based rationing might say “yes”…




This entry was posted in A Personal View, Community Health Councils, Good News, Patient representatives, Political Representatives and activists, Stories in the Media, Trust Board Directors on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

4 thoughts on “An advanced directive or living will – It’s important to specify, especially lying flat. Good news if you take action.

  1. Pingback: Death discussions ‘taboo’ for many in UK, survey finds | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

  2. Pingback: NHS reality. An NHS soapbox. Speakers' corner for the NHS.

  3. Pingback: ‘Do not resuscitate’ is doctors’ own choice for end-of-life care – but perish the thought to educate patients! | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

  4. Pingback: Demographics – it seems as if rural areas are being occupied by more elderly. The implications for service delivery without rationing (overtly) are macabre. | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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