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CAPACITY PLANNING · END-OF-LIFE DECISIONS

Living will or LPA — which one speaks for you?

An advance decision (the legal name for a living will) and a health & welfare LPA both plan for the moment you can't decide for yourself — and they can contradict each other.

The law has one clean starting rule: the later document can win — but only for the treatment decision it actually covers. England & Wales.

Facing a capacity decision for someone right now?Capacity check tool · Power of attorney guide

§1Two different documents for the same moment

They answer the same question two different ways.

They answer the same question two different ways: an advance decision records your answers; an LPA appoints your person.

Advance decision (ADRT)
Records your answers
A legally binding refusal of specified treatments, in specified circumstances, if you later lack capacity — no registration, no fee, but strict formalities where it matters most: a refusal of life-sustaining treatment must be written, signed, witnessed, and say in terms that it applies even if life is at risk. It can only refuse — it cannot demand a treatment, and it cannot refuse basic care and comfort.
Health & welfare LPA
Appoints your person
Appoints a human being — with judgment, and knowledge of you — to decide across situations no document can predict. Authority over life-sustaining treatment only exists if you signed that option in the form. Registration required (current fee) and it takes time — see the LPA guide. An old enduring power covers property and finance only, never health — see EPA vs LPA.
§2The collision rule — the reason this page exists

Whichever came later governs — for that decision.

When both documents exist and touch the same treatment decision, the Mental Capacity Act resolves it by date: the later document wins.

LPA made after the advance decision — and the LPA gives your attorney authority over that same treatment: your attorney's decision governs — the later LPA displaces the earlier AD for that decision. You chose a person after you chose an answer; the law honours the person.

Advance decision made after the LPA: the AD takes precedence for the treatment it specifies (provided it's valid and applicable) — your attorney cannot consent to treatment you've validly refused since appointing them. You chose an answer after you chose a person; the law honours the answer.

Neither document is "stronger." The statute simply trusts your most recent word. Which means the real risk isn't having both — it's having both and forgetting which came last.

§3Making them agree — the planning move

Not choosing between them. Deciding what each one covers.

The clean setup isn't choosing between them — it's deciding, on purpose, what each one covers. A common, coherent shape: the AD holds the few specific, researched refusals you are certain about; the LPA holds everything else, trusting your attorney's judgment for the situations you can't foresee.

Date everything — the whole regime runs on dates.

Tell your attorney the AD exists and where it lives — an unknown AD is a courtroom, not a plan.

Re-date deliberately after every revision — if you update one document, check the other still says what you mean, because the update just changed which one wins.

Where a dispute is genuinely likely — family conflict, contested beliefs about care — say so to a professional while drafting. A short conversation now beats a best-interests meeting later.

Keep both documents and their dates in one place your people can find
§4Neither document?

Here's what happens instead.

With no AD and no LPA, no one you chose holds the decision. Clinicians decide in your best interests under the Act, consulting those who care for you — your family is consulted, not in charge. For many households that discovery, not the paperwork, is what starts the planning.

Start your LPA Check the current fee
Before the window closes

Reading this is the first step. Caring for a Parent covers the LPA route, the OPG registration timeline, and the conversation that has to happen first — prepared personally from a short intake about your household.

See Caring for a Parent
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This area of the law changes.

Capacity law, LPA fees, and the guidance behind this page all shift over time. Leave an email and we'll send one short note if something on this page needs updating — only when it actually moves.

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FAQCommon questions

Frequently asked

In England and Wales, a valid and applicable advance decision to refuse treatment is legally binding.

Refusals of life-sustaining treatment need the extra written, signed, witnessed formalities and the statement that it applies even if life is at risk.
Neither, categorically.

On the same treatment decision, the most recent of the two governs, provided the statutory conditions are met — a later LPA needs to actually give the attorney authority over that treatment, and a later advance decision needs to be valid and applicable.
Only if the LPA was made after the advance decision and gives the attorney authority over that specific treatment.

If the advance decision came second, your attorney cannot consent to treatment you have validly refused.
No — it can only refuse treatment, and it can never refuse basic care and comfort.

To express positive wishes about your care, that is what your attorney's judgment and an advance statement of wishes are for.
Many households run both, deliberately: the advance decision holds a few specific, researched refusals; the LPA holds judgment for everything else.

Dated, consistent, and both findable by the people who would need them.
No fee and no registration.

A health and welfare LPA has a registration fee with the Office of the Public Guardian — see the current figure on our LPA fees page.
No — this page covers England and Wales only. Scotland and Northern Ireland have different capacity-law regimes.

Lasting Power of Attorney

Get the LPA moving — the document that needs lead time.

Start your LPA

Household dossier

Keep both documents, their dates, and their locations in one place your people can find.

See the household dossier
Related next steps
Lasting Power of Attorney
Both LPA types, in plain English
Enduring vs Lasting PoA
Found an old EPA? Start here
LPA cost calculator
The current registration fee
Capacity check tool
A quick orientation for a live decision

Informational, not legal advice, and covers England & Wales only. Mental Capacity Act 2005 s.25 governs the collision rule described on this page — verify anything you rely on at GOV.UK or take professional advice.

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