How to Make a Living Will in Scotland: Step-by-Step Guide

There Is No Official Form — and That Is Actually Fine

Scotland does not have a government-issued advance directive form. Unlike England and Wales, where the Mental Capacity Act 2005 provides a statutory framework for Advance Decisions to Refuse Treatment (ADRTs), Scottish advance directives exist under common law. There is no prescribed template, no registration body, and no mandatory format.

That means you can write your own — but it also means the burden of getting the content right falls entirely on you. A vague document that says "no extraordinary measures" will not hold up clinically. A specific one that names exact treatments and exact scenarios will.

Here is how to draft a living will that Scottish medical teams will follow.

Step 1: Decide What You Want to Refuse

Start by listing the specific medical treatments you want to refuse and the clinical scenarios in which the refusals should apply. The most common treatment refusals include:

• Cardiopulmonary resuscitation (CPR) — chest compressions and defibrillation
• Mechanical ventilation — breathing machines
• Clinically assisted nutrition and hydration (CANH) — feeding tubes and IV fluids
• Antibiotics for life-threatening infection — where the infection is a natural endpoint
• Dialysis — kidney filtration when recovery is not expected

For each refusal, specify when it applies. Common clinical scenarios include persistent vegetative state, advanced dementia with no prospect of recovery, end-stage terminal illness, severe brain injury with no meaningful prospect of consciousness, and irreversible organ failure.

Step 2: Include the Sanctity-of-Life Clause

This is the single most important sentence in any Scottish advance directive. You must explicitly state: "I maintain this refusal even if my life is at risk."

Without this clause, doctors may default to preserving life in an ambiguous situation — which is their legal obligation when the patient's wishes are unclear. The clause removes that ambiguity entirely.

Step 3: Write It in Clear, Clinical Language

Avoid euphemisms. "I don't want to suffer" does not give a clinician anything to act on. "I refuse mechanical ventilation, clinically assisted nutrition and hydration, and cardiopulmonary resuscitation if I am in a persistent vegetative state or have advanced dementia with no medical prospect of regaining decision-making capacity" does.

Use medical terminology alongside plain-English explanations where it helps clarity. The goal is a document that a doctor reading it at 3am in an emergency department can understand without interpretation.

Step 4: Sign and Date the Document

Sign in your own handwriting. Print your full legal name and date the document. If you cannot sign yourself, seek advice from a Scottish solicitor before relying on an alternative signing arrangement.

Step 5: Have It Witnessed

The witness must be an independent adult — someone who is not your spouse, civil partner, blood relative, or named welfare attorney. A neighbour, friend, or work colleague all qualify.

Using your GP or a solicitor as the witness is ideal but not required. Having a medical professional witness the signing adds an extra layer of evidence that you had capacity at the time, which strengthens the document if it is ever challenged. But a lay witness is perfectly valid.

The witness should sign and print their name, address, and the date.

Step 6: Deliver a Copy to Your GP

This is where most people stop — and it is exactly where things can go wrong. A living will stored in a desk drawer at home is invisible to the NHS Scotland emergency system. The clinical infrastructure that paramedics, NHS 24, and hospital doctors actually check is the Key Information Summary (KIS) — a digital database linked to your electronic patient record.

To get your directive onto the KIS:

1. Book an appointment or write a letter to your GP practice
2. Ask them to scan the document into your electronic patient record
3. Request a clinical alert flag on your record so any clinician opening it sees the directive immediately
4. Ask them to upload your treatment preferences and welfare attorney details to the KIS database

Once your preferences are on the KIS, the Scottish Ambulance Service, NHS 24 out-of-hours, and any hospital in Scotland can access them instantly.

Step 7: Give Copies to Key People

Distribute copies to your named welfare attorney (if you have one), your next of kin, and any hospital consultant you see regularly. Some people carry a wallet card noting that an advance directive exists and where the original is stored.

Do You Need a Solicitor?

No. There is no legal requirement to use a solicitor when making a living will in Scotland. A self-drafted document can be legally valid when it is made with capacity, is informed and free from coercion, clearly applies to the clinical situation, and is properly signed, witnessed, and specific in its refusals. Delivering it to your GP helps clinicians find it but is not a condition of validity.

That said, if you are also setting up a Welfare Power of Attorney (which requires registration with the OPG Scotland and a Schedule 1 capacity certificate), it makes sense to ask your solicitor or other certifying professional to review the advance directive at the same time.

For a complete drafting framework that includes the clinical wording templates recognised by the BMA and NHS Scotland, along with the GP letter template and KIS upload instructions, the Scotland Advance Directive Planning Kit covers every step from first draft through NHS integration.

See more Scotland guides →