Guidelines in respect of advance directives: the position in England

The fundamental aim of the advance directive is to provide a means for the patient to continue to exercise autonomy and shape the end of his/her life. The principle is not new. Patients who are aware of approaching death have for many years discussed with their health-care team how they wish to be treated. The advance directive registers these views in a more formal way. However, inconsistencies persist in the understanding of the legal issues around advance directives in the UK, and suggest that national guidelines would encourage National Health Service trusts to develop local policies to improve understanding and compliance with the law. This article draws on English law to address misunderstandings and proposes which information advance directives should include.