Page 3 - Guide-to-Advance-Statements

2. WHAT AN ADVANCE STATEMENT DOES

People who suffer from a mental disorder (including dementia) may be subject to receiving compulsory
treatment or hospitalization, subject to various safeguards.

Because compulsory treatment is possible it is important that those patients have the opportunity to make
their views clear and this is the reasoning behind the legislation.

The Advance Statement has status in law and must be taken into account in any treatment decisions taken in
future in respect of the person making the statement.

Typically an Advance Statement may outline preferences for particular drugs or types of treatment and also
drugs, treatments or therapies not wanted by the patient. Someone may state “I do not want tranquilizer X
because it always makes me feel really ill” or “I do not want treatment Y because I always put on weight”.
Doctors must take these preferences into account. A doctor could decide not to follow what is in an
Advance Statement but if he or she does, the reason must be stated in writing, and copied to various parties
including the Mental Welfare Commission. Any such decision could be reviewed at a Mental Health
Tribunal.

3. THE FORMOFANADVANCE STATEMENT

Anyone can make an Advance Statement – even people under 16 – provided they can understand the nature
and consequences of the procedure and treatments. You do not need to be ill to make a statement – you
can make one covering possible future illness.

To be valid a statement must be in writing and clear – with the full name and address of the person making
the statement properly mentioned. In addition the statement must be signed and also witnessed. Not
everyone can be a witness to an Advance Statement – witnesses can only be drawn from a limited group of
people, principally health professionals, social workers, care professionals and solicitors. The witness must
certify in writing that the person signing the statement did understand the importance of the document and
what it was intended to achieve. The witness would normally add a docquet as follows “I certify that in my
opinion Mr. X has the capacity of properly intending the wishes set out above. I hereby witness his
signature”.

An Advance Statement, or a similar signed nomination, can be used to appoint a “Named Person” who
would look after the person’s interests if treatment were required under the Act. A Named Person has
limited powers and these are only related to treatment. The Named Person could be the same person as a
Welfare Attorney – and often is – but a Welfare Attorney has to be appointed by a different process than an
Advance Statement.

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