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advance directive a declaration by a person in relation to medical treatment (usually to instruct that it stop) to provide for a situation in which he might himself be unable to comment, e.g. the so-called living will. The US Supreme Court established the right for a person to refuse medical treatment, which in the case of a comatose patient can be difficult to establish. This is an issue that is troubling most legal systems because it raises moral, philosophical and practical questions. In the UK the directive is legally effective because treatment requires consent. It need not be in writing. It cannot, however, compel doctors to cease treatment so as to mercy-kill or provide treatment which they do not consider to be in the best interests of the patient.