Advance directives are not legally binding in Norway. People do nevertheless write them.

In some situations, patients have a right to decide whether treatment that is life-saving, at least in the short run, should be provided or not. According to section 4-9 of the Patients’ Rights Act, a patient with serious personal convictions may refuse to receive blood or blood products (e.g. a Jehovah’s witness). Similarly, a person may refuse to call off an ongoing hunger strike.

Conditions surrounding the writing, validity and registering of an advance directive

In Norway, there is an organisation called “mitt livstestamente” which offers help, advice and assistance in filling in advance directive forms. Independent witnesses are required.

What an advance directive can cover

An advance directive can cover:

• The treatment of medical conditions;
• The treatment of a psychiatric condition;
• Care and welfare decisions;
• Research;
• Life-supporting treatment; and
• Life-saving treatment.

It cannot cover the refusal of basic care.

Obligation to comply with instructions contained in an advance directive

Paragraph 7 of The Health Personnel Act of 1999 deals with the question of emergency health care. It states: Health personnel shall immediately provide the health care they are capable of when it must be assumed that the health care is of vital importance. Pursuant to the limitations laid down by the Patients’ Rights Act § 4-9, necessary health care shall be given, even if the patient is incapable of granting his consent thereto, and even if the patient objects to the treatment.

However, § 4-9 of the Patients’ Rights Act states that a dying patient is entitled to object to life-supporting treatment. If a dying patient is incapable of communicating their wishes concerning treatment, the health care personnel may withdraw health care provided that the patient’s next of kin so requests and that the health care personnel, based on an independent evaluation, find that this also corresponds with the patient’s wishes. Presumably, such wishes could be recorded in an advance directive.

Health care personnel must ensure that a patient is of age, that they have been given adequate information and that they have understood the possible consequences on their own health of refusing treatment.

Amending, renewing and cancelling advance directives

An advance directive may be withdrawn or amended at any time by a person with capacity.