End-of-life decisions as an attorney
Guidance from Estate Advisory Group
Written and legally reviewed by Ramani Gill TEP, Solicitor and private client practitioner·Last reviewed 13 August 2026
The legal question is always the same: what would the donor want, and what is in their best interests now?
Decisions you may face
- Moving from active treatment to palliative care.
- Hospice, hospital, care home or home as the place of death.
- Clinically assisted nutrition and hydration, where the LPA gives you that power.
- Whether to consent to a treatment with a small chance of benefit and a heavy burden.
How to decide well
- Start from anything the donor said or wrote, including any advance decision or ReSPECT record.
- Ask clinicians for the realistic outcomes, not just the options.
- Consult the family and record their views, while remembering the decision is the donor's interests, not the family's wishes.
- Write down what you decided and why, on the day.
A worked example
Consider Grace, in the advanced stages of cancer, who made a health and welfare LPA two years earlier appointing her husband Tom with option A for life-sustaining treatment. When a further course of chemotherapy is offered with a small chance of extending life by a few weeks at significant cost to Grace's remaining quality of life, Tom is asked to decide because Grace can no longer weigh up the choice herself. He recalls conversations they had when she was well, in which Grace was clear she would rather have fewer good weeks than more difficult ones, and he declines the further treatment in favour of a move to palliative care at the hospice she had visited and liked. He writes down that reasoning, and the clinical team's own account of the realistic prognosis, on the day the decision is made.
Where the family disagrees with the attorney
It is not unusual for an attorney's best-interests decision at the end of life to be different from what some family members would have chosen. The law is clear that the decision belongs to the attorney with the relevant authority, informed by consultation, not by family vote. Where disagreement is serious and cannot be resolved through conversation with the clinical team, either side can ask the Court of Protection for an urgent decision, though in practice most disagreements are resolved through a further, better-facilitated best-interests meeting rather than litigation.
Limits
No LPA can authorise assisted dying
An attorney can refuse or consent to treatment. Nothing in a Lasting Power of Attorney permits anyone to end the donor's life, and any instruction attempting it is invalid.
Common questions
Can I insist my parent dies at home?
You can decide on place of care in their best interests where they lack capacity, subject to what is clinically and practically possible.
Do I need the whole family to agree?
No, but you must consult them, and unresolved disagreement can be taken to the Court of Protection.
What if the donor never told me their wishes?
Base the decision on their known values, past choices about similar situations and anything family or clinicians can add, always applying the best-interests test rather than guessing at a specific instruction that was never given.
Does withdrawing treatment need a court order?
Not usually, where the decision is agreed between the attorney and the clinical team and falls within an uncontested best-interests process; a court application is only needed where there is genuine, unresolved disagreement.
Read next
Where this fits
This page is part of Health and care decisions. The pages below take it further.
- Health & Welfare LPA
The LP1H: care, treatment decisions and life-sustaining treatment.
- Make an LPA online
The whole journey end to end: questions, documents, signing and registration.
Review and sources
Reviewed by Ramani Gill TEP, Solicitor and private client practitioner. Last reviewed 13 August 2026. We recheck fees, forms and Office of the Public Guardian guidance whenever they change — see our editorial policy.
Official sources
Most people make both LPAs
Property & Financial Affairs and Health & Welfare together cost £79 instead of £98 separately.
The Office of the Public Guardian charges a separate £92 to register each LPA.
This is general information about how Lasting Powers of Attorney work in England and Wales. It is not legal advice about your situation. What we do and do not do.
Published by Estate Advisory Group