Advance Healthcare Directive Ireland: How to Make One (2026)
General legal information for Ireland. Last updated 22 September 2026.
Most people assume that if they become seriously ill and cannot speak for themselves, their spouse, children or EPA attorney will decide their medical treatment. In Ireland, that is not how the law works. Unless you have made an advance healthcare directive, nobody has an automatic legal right to refuse treatment on your behalf. This guide explains what an advance healthcare directive is, what it can and cannot do, and how to make one that will be respected under the Assisted Decision-Making (Capacity) Act 2015.
What is an advance healthcare directive?
An advance healthcare directive (AHD) – sometimes called a “living will” – is a written statement, made while you have capacity, setting out the medical or surgical treatments you want to refuse in the future if you lose the ability to make or communicate those decisions yourself. It can also record treatments you would like to receive, and it can appoint a trusted person, called a designated healthcare representative, to interpret your wishes and speak for you.
AHDs have a statutory footing in Ireland under Part 8 of the Assisted Decision-Making (Capacity) Act 2015, which was fully commenced on 26 April 2023. The Decision Support Service (DSS), a function of the Mental Health Commission, oversees the regime and publishes a free template form and guidance booklet.
An AHD only comes into effect if you lack capacity to make a particular treatment decision at the time it arises. While you have capacity, your own contemporaneous decisions always take priority.
What an advance healthcare directive can and cannot do
Refusals of treatment are legally binding
A refusal of treatment in a valid AHD is legally binding on the healthcare professionals treating you, provided the treatment proposed is the one you described and the circumstances you set out have arisen. This includes refusing life-sustaining treatment such as resuscitation, ventilation or artificial feeding – but a refusal of life-sustaining treatment must be stated expressly and in clear terms, naming both the treatment and the circumstances.
Requests for treatment are not binding
You can ask for particular treatments, but a request is not binding. The treating team must take it into account if it is relevant to your condition, but they are not obliged to provide it.
Limits you should know about
Under the 2015 Act and HSE guidance, an AHD cannot be used to:
- Refuse “basic care” – hygiene, warmth, and food and drink given by mouth.
- Request anything unlawful, such as assistance to end your life. Refusing treatment is not the same as asking someone to end your life.
- Bind clinicians in circumstances you did not describe. If you refuse a procedure in one scenario and a different scenario arises, the directive may not apply, so precise wording matters.
The Act also contains a specific carve-out for certain treatment for a mental disorder given to a person involuntarily detained under the Mental Health Act 2001; an AHD is not binding for that treatment, although it should still be considered.
The designated healthcare representative
You may name one person (with an optional alternate) as your designated healthcare representative. Depending on the powers you give them in the AHD, they can advise on and interpret your wishes, and consent to or refuse treatment on your behalf, always within the scope of what your directive says. They act only when you lack capacity for the decision in question.
Your representative must be 18 or over and willing to act. Certain people are excluded – for example someone convicted of an offence against you or your child, the owner or registered provider of the nursing home or mental health facility where you live (unless a relative), or a paid carer or healthcare provider (unless a relative or primary carer). Once acting, the representative must keep a written record of each decision within 7 days, give you a copy if you regain capacity, and provide it to the DSS on request. The DSS can investigate complaints about a representative.
How to make an advance healthcare directive in Ireland
There is no fee. You can use the DSS’s template form or draft your own document, and you do not have to use a solicitor, although solicitor drafting is strongly recommended where you are refusing life-sustaining treatment or where family disagreement is likely. To be valid, your AHD must:
- Be made by an adult (18 or over) who has capacity at the time.
- Be in writing – you can prepare it by video or audio, but a written version must be produced for signing.
- State your full name and, if you are appointing one, the name of your designated healthcare representative.
- Identify clearly each treatment you refuse and the circumstances in which the refusal applies; life-sustaining refusals must be spelled out expressly.
- Be signed by you in the presence of two witnesses, both aged 18 or over, at least one of whom is not an immediate family member.
- Be signed by your designated healthcare representative (if any) in front of the same two witnesses.
Unlike an enduring power of attorney, an AHD does not have to be registered with the DSS. Once signed and witnessed, it is effective. Give copies to your GP, any consultant treating you, your nursing home if relevant, your representative and your solicitor, and tell your family it exists. Healthcare professionals are required to check whether a person who lacks capacity has an AHD.
Changing or cancelling your directive
You can revoke your AHD at any time while you have capacity; a revocation must be in writing. Any change must also be in writing, signed before two witnesses and signed by your representative if you have one. Review it regularly, especially after a new diagnosis or major treatment, because a directive written for one condition may not fit another. Acting inconsistently with your directive while you have capacity – for example consenting to a treatment you had refused – can call it into question.
AHD vs enduring power of attorney: do you need both?
Yes, for complete cover. An enduring power of attorney covers your property, finances and personal welfare, but it expressly cannot authorise your attorney to make healthcare treatment decisions. Only an AHD does that. The DSS specifically recommends making both. A solicitor you instruct can prepare the two documents together so that your attorney and your healthcare representative are aligned and your wishes are consistent across both.
When to get legal advice
A poorly worded directive is the most common reason an AHD is not followed. If you are refusing life-sustaining treatment, have a progressive condition such as dementia or motor neurone disease, expect disagreement among family members, or are unsure whether a particular wish is lawful, read our guide to a Capacity & ADMCA advice consultation with an Irish solicitor. You can also see our full range of capacity and decision-support services, including decision-making assistance and co-decision-making agreements under the 2015 Act.
Frequently asked questions
Is a living will legally binding in Ireland?
Yes, if it is a valid advance healthcare directive under the 2015 Act. Refusals of treatment are binding where the directive is valid and applicable; requests for treatment must be considered but are not binding.
What is a designated healthcare representative?
A person you name in your AHD to interpret your wishes and, if you give them the power, to consent to or refuse treatment on your behalf when you lack capacity. They must be over 18 and must keep records of decisions made.
Do I need a solicitor to make an advance healthcare directive?
No, and it is free to make. However, because refusals must be precisely worded to be effective, solicitor drafting is advisable for refusals of life-sustaining treatment or where your circumstances are complex.
Does an advance healthcare directive need to be registered with the Decision Support Service?
No. Unlike an EPA, there is currently no registration requirement and no central register. Effectiveness depends on the people treating you knowing it exists, so distribute copies widely.
Can my enduring power of attorney make medical decisions for me?
No. An EPA covers property, finances and personal welfare only; it cannot authorise healthcare treatment decisions. You need an advance healthcare directive for that.
This guide is general information only and is not legal advice. Every situation is different – to discuss your own circumstances, read our guide to a consultation with a solicitor of your choice.
