Advance decisions to refuse treatment component of the Mental Capacity Act

In January 2007 a project team was commissioned by the Department of Health to develop specialist guidance for advance decisions to refuse treatment (ADRT). ADRT is one component of the Mental Capacity Act (MCA) 2005, which provides a statutory mechanism protecting the advance decision-making process for people, particularly those who have a long-term condition and those approaching end-of-life care. The ADRT project team is hosted by the Mid-Trent Cancer Network and works in close association with Care Services Improvement Partnership East Midland. ADRT is an integral part of advance care planning and its creation can protect patient choice before capacity is lost, often allowing death with privacy and dignity. Since October 2007 professionals and organizations have a legal duty to support ADRT and the MCA implementation. The aim of this article is to provide a practical introduction to ADRTs, focusing on the content of the ADRT specialist guidance and how this can be used to support implementation, education and training related to ADRT. Advance care planning is a significant component of the recently published End-of-Life Care Strategy.