Commentary on Sections Advance statements: effect
539.Section 276 sets out the effect of an advance statement which has been made in accordance with section 275, and which has not been withdrawn.
540.If the Tribunal is making a decision, subsection (1) requires it to have regard to the terms of any extant advance statement made by the patient concerned, if the Tribunal is satisfied that:
	because of mental disorder, the patient’s ability to make decisions about his or her treatment is significantly impaired;
	the statement was properly made (that is, it is in compliance with section 275(2));
	the statement covers any aspect of the measures or treatment which might be authorised or no longer authorised by the decision to be made by the Tribunal; and
	the Tribunal is satisfied there has been no material change in circumstances since the statement was made.
541.Subsection (3) provides that, where any person is giving treatment authorised under the 2003 Act or the 1995 Act (for example, the responsible medical officer), that person has to have regard to any extant advance statement made by the patient concerned, if satisfied that the patient’s current decision-making ability is significantly impaired by virtue of mental disorder.
542.Any designated medical practitioner making decisions under the 2003 Act must also have regard to any extant advance statement.
543.The Tribunal must consider an advance statement (or a withdrawal of a statement) to be valid unless the contrary appears. If the Tribunal has considered an advance statement as valid, it should be presumed to be valid by any person giving treatment authorised by a decision of the Tribunal. Similarly, if treatment is being given otherwise than by virtue of a decision of the Tribunal, then the person giving treatment must consider a statement (or its withdrawal) to be valid unless the contrary appears to be the case.
544.Wherever a decision of the Tribunal or a designated medical practitioner, or treatment given under authority of the 2003 Act or the 1995 Act, conflicts with a valid extant advance statement, then the Tribunal or person concerned must record the circumstances and their reasoning in writing, notify various parties including the patient who made the statement and the Commission, and place a copy of the record in the patient’s medical records.