3.4 Outline ethical and legal issues that may arise in relation to advance care planning outside of own job role

This. guide will help you answer3.4 Outline ethical and legal issues that may arise in relation to advance care planning outside of own job role.

Advance care planning allows people to make decisions about their future health and care, should they lose the ability to communicate these wishes later on. This planning can include statements about general preferences, formal advance decisions to refuse certain treatments, or appointing someone to make decisions on their behalf.

Health and social care workers must follow protocols set within their own roles. Sometimes they encounter ethical and legal issues linked to advance care planning that fall outside what their job covers. Understanding these issues ensures people’s rights are respected and protects the worker from acting outside lawful or ethical boundaries.

Ethical Issues Outside of Own Job Role

Respecting Autonomy

Every adult has the legal right to make their own decisions if they have the mental capacity to do so. Supporting people to have a say in their future care shows respect for their autonomy. If someone asks for help making detailed advance care plans beyond your training or job description, this puts you in a difficult position.

Issues include:

• Risk of influencing decisions when not qualified
• Creating plans that may not reflect the person’s true wishes if you are not skilled in facilitating sensitive conversations
• Balancing personal beliefs with the person’s choices

It is good practice to support people to access the right professional, like an advanced care planning facilitator, nurse, doctor, or social worker.

Informed Consent

For advance care planning to be respectful and valid, the person must understand their choices and implications. If a worker is involved in care planning outside their role, the person could make decisions without full understanding.

Concerns include:

• Giving incomplete or incorrect information
• Not recognising questions or doubts the person may have
• Not having training to assess if someone has capacity to consent

Supporting informed consent must be left to professionals trained in this area. Your job may involve signposting or supporting access, not giving full explanations about medical options.

Avoiding Coercion or Undue Influence

Some people are vulnerable and could be influenced by workers they trust. Asking or prompting someone to complete advance care plans can cross ethical boundaries if you do not have the right skills or knowledge. Power imbalances, family pressure, or even a wish to please staff can affect genuine choice.

Ethical risks can involve:

• Worker unintentionally leading conversations
• Pressuring the person to make specific choices
• Having assumptions about quality of life that do not match the individual’s views

Remaining neutral and referring to the right professional protects both you and the person.

Confidentiality and Privacy

Advance care plans often contain very sensitive personal information. If the creation or sharing of such plans happens beyond the scope of your job, there are ethical risks.

Common concerns:

• Sharing information with people not authorised to receive it
• Storing plans incorrectly
• Discussing content inappropriately even with other team members

It is necessary to follow procedures carefully and take extra care when dealing with information outside your usual responsibilities.

Cultural and Religious Respect

Choices about care, including end-of-life decisions, may be influenced by culture or faith. Without suitable training you may not recognise the significance of some wishes or symbols in advance care planning. This can lead to plans that do not respect the person’s values.

Issues include:

• Failing to ask about or document important beliefs
• Not recognising requests linked to culture or religion
• Allowing personal views to affect the planning process

Referring to a specialist or involving someone who understands the person’s background is preferable to making mistakes out of lack of insight.

Legal Issues Outside of Own Job Role

Mental Capacity Act 2005

The Mental Capacity Act 2005 in England and Wales sets out laws to protect people who may lack capacity, and describes how decisions must be made. Many aspects of advance care planning sit within this law.

Legal issues arise when:

• A worker assumes someone lacks capacity without proper assessment
• Advance decisions are written or witnessed incorrectly
• Documents are signed without confirming understanding

Only certain professionals are trained and authorised to carry out capacity assessments or witness legal documents. Acting outside your role could make the plan invalid and put both you and the organisation at risk.

Advance Decisions to Refuse Treatment (ADRT)

An advance decision lets an adult refuse specific treatments in future, even if this may result in death. These are legally binding if correctly made under the Act.

Risk areas:

• Helping to write or amend ADRTs when not qualified
• Witnessing signatures or giving advice about medical treatments you are not trained in
• Not understanding which treatments can be refused and in what circumstances

Mistakes can mean a document is ineffective or even harmful. Only legally appropriate workers, often doctors or solicitors, should be involved in detailed discussions or documentation.

Lasting Power of Attorney (LPA)

A Lasting Power of Attorney is a legal document allowing someone (the ‘donor’) to appoint another person (the ‘attorney’) to make decisions if they lose capacity.

Legal issues outside your role:

• Assisting with the completion of LPA forms
• Giving advice on choosing attorneys
• Explaining legal rights and responsibilities

Only authorised staff or legal professionals should guide someone through an LPA. If a worker tries to offer this support without correct status or training, the document may be challenged or be legally invalid.

Rights under the Human Rights Act 1998

Advance care planning can touch on fundamental human rights, such as the right to private life, freedom from degrading treatment, or even the right to life. Workers outside their role may make errors that affect someone’s rights.

Risks involve:

• Placing limits on care based on personal judgments rather than the person’s will or the law
• Failing to protect the person from discrimination

It is better to refer or seek legal advice in such sensitive situations.

Data Protection Act 2018 and GDPR

Handling, storing, or sharing advance care plans must comply with the Data Protection Act 2018 and General Data Protection Regulation (GDPR).

Legal issues outside your role:

• Passing on notes or details incorrectly
• Entering data in electronic systems without authority
• Emailing or discussing plans without permission

Breaking these rules can result in disciplinary action and legal proceedings.

Recognising Scope of Practice

Understanding what your job role includes is key. The scope of practice is what you are trained and authorised to do. Advance care planning is a specialist activity in many cases. The Code of Conduct for Health and Social Care Workers requires you to work within your ability and seek help where needed.

If someone requires support with advance decisions, legal documents, or complex wishes, always seek support from a senior, manager, or specialist.

Main points:

• Only carry out tasks you are competent to do
• Record concerns or requests and follow escalation procedures
• Do not feel pressured to give advice, witness signatures, or discuss sensitive information if this is not your job

Supporting the Person in Accessing Advance Care Planning

There are ethical and legal ways you can help without working outside your role:

• Provide general information leaflets or signpost to reputable sources
• Support access to appropriate professionals (doctors, solicitors, advocates)
• Help arrange appointments or facilitate conversations with family or staff who are qualified
• Listen carefully and record wishes objectively, passing these to the right person

Your support and encouragement is still valuable, even if you are not the main person completing the advance care plan with them.

Real-World Examples

Acting Outside Role

A care assistant witnesses an ADRT being signed for the person they support, believing this is helpful. Later, the document is disputed in hospital: the assistant is not legally recognised as a witness, and no assessment of capacity was completed. This leaves the person without a valid plan and the worker open to disciplinary action.

Staying Within Role

A support worker listens to a person explaining they want to make decisions about their end-of-life care. The worker notes this, provides an NHS leaflet about advance care planning, and refers the request to their manager. The manager arranges for a nurse and advocate to meet the person and support them properly. This approach respects both ethical and legal guidelines.

What to Do if Unsure

If someone asks you for help with advance care planning and you think it is beyond your remit:

• Record their request honestly, factually, and without personal comment
• Let your supervisor or management team know promptly
• Explain you will get a colleague with the right skills to help
• Never give advice on treatments, legal documents, or consent if you are unqualified

Acting transparently protects you and improves outcomes for the person you support.

Key Legislation and Professional Guidance

• Mental Capacity Act 2005
• Human Rights Act 1998
• Data Protection Act 2018
• General Data Protection Regulation (GDPR)
• Care Quality Commission (CQC) guidance for regulated services
• Local authority or NHS trusts’ policies on advance care planning

Always follow the latest policies in your workplace.

Final Thoughts

Advance care planning is important, as it helps people shape their care and prepare for the future. Yet, you may face challenges if the support requested sits outside your professional boundaries. Ethical and legal issues can arise if you give advice, witness documents, or handle information you are not authorised to deal with.

Stay aware of your role and training. Support people by listening to their wishes and making sure the right professionals are involved. If you are unsure, ask for advice and follow organisational guidelines without delay.

Your contribution is meaningful. By working within your boundaries and knowing when to refer, you protect the rights and welfare of those you care for, while also guarding your own position in the workplace. This balanced approach builds trust and ensures the best possible care is delivered.