Scotland and Northern Ireland


In Scotland, Advance Decisions are known as Advance Directives. Advance Directives are not recognised in legislation as they are in England and Wales, but are still widely recognised and used by healthcare professionals. If a decision ever had to be made in court, it is likely that the Scottish courts would take the same approach as England and Wales and say that a clear and specific Advance Directive should be followed.

An Advance Directive can be used as evidence of your wishes if you lack capacity. Under the Adults with Incapacity (Scotland) Act, a person’s past and present wishes should be taken into account when decisions about medical treatment are being made on their behalf.

Northern Ireland

The Mental Capacity Act (Northern Ireland) was passed in 2016 but has not yet come into force. A Mental Capacity Act Code of Practice is being written which should explain what makes an Advance Decision ‘effective’ in Northern Ireland. Currently, Advance Decisions are given legal effect in Northern Ireland under common law, which means a clear and specific Advance Decision to refuse treatment must be followed. Until the Code of Practice is published, we recommend that you follow the instructions for people in England and Wales to help ensure your Advance Decision is respected.