People can make a decision in advance to refuse treatment in case they lose capacity to make such decisions in the future. There are a wide range of advance decisions that people will want to make, including written and oral decisions, those made a long time before a person loses capacity and those made, for example, just before an operation takes place.
The Mental Capacity Act 2005 (MCA) sets out statutory rules governing advance decisions and introduces clear safeguards that are flexible enough to cover all these situations. A registration scheme would impose unnecessary bureaucracy on such decisions. The MCA code of practice will make clear that if an advance decision is not recorded on someone's medical record, they will need to think about what steps they will take to alert others to its existence.