Empowering choices: How LPAs shape decisions on Life Sustaining Treatment

A Lasting Power of Attorney (LPA) is a powerful legal document that allows an individual (the “donor”) to appoint one or more persons (the “attorneys”) to make decisions on their behalf if they lose mental capacity. There are two types of LPAs in the UK: one for property and financial affairs and another for health and welfare. The health and welfare LPA is particularly significant when it comes to decisions about medical treatment, including life sustaining treatment.

Understanding Life-Sustaining Treatment

Life-sustaining treatment refers to any medical intervention that serves to prolong life without necessarily curing the underlying condition. This can include mechanical ventilation, artificial nutrition and hydration, cardiopulmonary resuscitation (CPR), and certain medications.


Authority Under a Health and Welfare LPA

When creating a health and welfare LPA, the donor can specify whether their attorney has the authority to make decisions about life-sustaining treatment. This decision is crucial and requires careful consideration.

  1. Granting Authority: The donor can explicitly grant their attorney the authority to consent to or refuse life-sustaining treatment on their behalf. If granted, the attorney can make these critical decisions in line with the donor’s best interests and any known wishes or preferences.
  2. Refusing Authority: Alternatively, the donor can choose to withhold this authority, meaning the attorney cannot make decisions about life-sustaining treatment. In such cases, the responsibility falls to medical professionals, who must act in the best interests of the donor, often seeking input from family members or close friends.


Making the Decision

The decision to grant or withhold authority over life-sustaining treatment should be guided by thorough reflection on the following factors:

  • Personal Values and Beliefs: The donor should consider their own values, beliefs, and preferences regarding end-of-life care and medical interventions.
  • Medical Scenarios: Understanding different medical scenarios and potential interventions can help the donor make an informed choice about the level of authority they wish to grant their attorney.
  • Discussions with Potential Attorneys: It is crucial for the donor to discuss their wishes with their prospective attorneys to ensure they are willing and able to make these decisions, should the need arise.


Imagine a scenario where Jane, a donor, creates a health and welfare LPA and grants her daughter, Sarah, the authority to make decisions about life-sustaining treatment. Jane has expressed her wish not to undergo invasive procedures that would extend her life without improving its quality. If Jane loses capacity and faces a situation requiring such a decision, Sarah can refuse the treatment in accordance with Jane’s wishes, ensuring her preferences are respected.


Granting an attorney the authority to make decisions about life-sustaining treatment under an LPA is a significant and deeply personal decision. It provides a mechanism for ensuring that an individual’s preferences and values regarding end-of-life care are upheld, even when they can no longer communicate their wishes. Thorough discussions and careful consideration are essential to making an informed choice that aligns with the donor’s values and provides clear guidance to the attorney.


By understanding the implications and responsibilities associated with this authority, individuals can better navigate the complexities of creating an LPA and ensure that their end-of-life care aligns with their personal beliefs and preferences.


For an informal discussion, or if you have any questions about how to make a lasting power of attorney, please contact us.

About the authors

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Michael Derrick


Expert advisor on estate administration, will drafting, inheritance tax planning and Lasting Power of Attorney.

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