Towards the end of life you might want to make some decisions about your care, including any instructions for refusing treatment.
It can sometimes be very difficult to know what care and treatment to have when you are near the end of life.
Relieving your symptoms
It is important to remember that doctors and nurses can treat most symptoms, especially pain, to help you feel comfortable.
Make sure that you talk to your medical team about any symptoms or problems that you have. Find out what treatment is available. You might feel differently about treatment if your pain and other symptoms can be relieved.
Making your decision
Some people feel so tired and weak that they don’t want to have medicines that could extend their life. For example, someone who gets a severe infection could choose not to have antibiotics, even if they know that without them they will die very soon.
Doctors should explain what happens if you refuse the medicines, and support you if you decide that you don't want the treatment. Your doctor can note your wishes in your medical notes. You can change your mind later if you want to.
In the UK, as an adult you can refuse medical care and treatment if you don't want to have it. Doctors can only give you treatment and medicines with your permission. You can set out your instructions about treatments you would like and which you don't want in a document called an advance decision. This is called an advanced directive in Scotland.
Explaining your wishes to family and friends
It can sometimes be very hard for your family and friends to accept that you don’t want any further treatment. You could ask your doctor or nurse to talk to your family and explain how you feel, if this is a problem for you.
When you have a terminal illness, your doctors may explain that they won't try to restart your heart and lungs if they stop working. Trying to restart them is called cardiopulmonary resuscitation (CPR).
Of course, it might be very upsetting for you and your family to hear this. But your doctors are saying this because trying to start your heart and lungs again won't work if you are very ill with advanced cancer.
You also have the right to refuse CPR. You can discuss your views about CPR with your healthcare team. You can tell them whether or not you want them to try it.
The doctors take your wishes into account, but you can’t insist on having CPR. Your healthcare team can decide not to try it if they think it won’t work.
Your doctors write the decision in your medical notes. That way, everyone looking after you is aware of it. You can ask for a second opinion with a different doctor if you want to discuss the decision further.
The Resuscitation Council UK website has more information about resuscitation and your rights.