End of Life Care, DNACPR and Advance Decisions

This end of life care course covers DNACPR decisions, advance decisions to refuse treatment, powers of attorney and care in the last days of life, for health professionals across the UK. It is written for doctors, nurses, midwives, nursing associates, paramedics, pharmacy professionals, allied health professionals, dental professionals and any other registrant who cares for people approaching the end of life, whether in hospital, general practice, a care home, a hospice or a patient's own home.

Decisions near the end of life are where clinical judgement, law and communication meet most sharply. A DNACPR form that nobody can find, a resuscitation decision made without telling the family, or an advance decision that staff are unsure whether to follow can all cause lasting harm and lead to complaints, inquests and regulatory concerns. The course explains the ethical principles behind these decisions, how capacity and best interests apply to life-sustaining treatment, how to make, discuss, record and review a DNACPR decision lawfully, and how to check an advance decision or a lasting power of attorney before relying on it.

It is designed to take approximately 2 hours, including reading, reflection points, a written reflective account and a 15-question assessment. It is self-paced, so you can complete it in one sitting or across several shifts. You buy and take it on our course portal; the course catalogue lists related titles. Healthcare Practise UK is an independent provider. We are not affiliated with any UK regulator or the NHS, and no regulator has reviewed this course.

There is no single UK statute on end of life care, and health law is devolved. The course sets out the framework nation by nation, then maps it to the professional standards every registrant works to.

The course also states the current law on assisted dying and euthanasia in each nation, as at October 2026, and explains why professionals should follow the law as it stands rather than speculate about change. Your regulator's current standards and the law in your nation always take precedence over any course.

The course has six teaching modules, followed by key points, a references list with a quick-reference table, and your reflective account.

• Foundations of end of life care. What end of life care and palliative care cover, the ethical principles (including the difference between treatment and basic care), the legal framework in each nation, and how to recognise, and talk honestly about, the possibility that someone is dying.
• Capacity, best interests and treatment decisions. Capacity for end of life decisions, the section 4 best interests checklist and its safeguard for life-sustaining treatment, why withholding and withdrawing treatment are treated alike, and decisions about clinically assisted nutrition and hydration.
• CPR and DNACPR decisions. What CPR can realistically achieve, the three types of CPR decision, the duty to involve the patient, a structure for the conversation, recording and sharing the decision across services, and the errors that recur in complaints, such as treating DNACPR as "do not treat".
• Advance care planning and advance decisions. Advance statements and ReSPECT, the formal requirements for an advance decision refusing life-sustaining treatment, a validity and applicability check, health and welfare attorneys, and the different position in Scotland and Northern Ireland.
• Care and communication in the last days of life. Conversations about dying, the five priorities for care of the dying person, anticipatory medicines and the doctrine of double effect, and supporting families before and after death.
• Requests to hasten death, disagreement and personal resilience. Responding to a request to die without abandoning the person, conscientious objection and its limits, resolving disagreement with families up to the Court of Protection, and looking after yourself and your team after difficult deaths.

Each module ends with key points, and worked examples show the law applied to familiar situations, from a care home resident with a DNACPR form who develops a chest infection to an unconscious patient whose advance decision refuses dialysis.

Reflection points run through the modules. At the end you write a short reflective account to three prompts: what you have learned about making and communicating end of life and DNACPR decisions; an anonymised situation where an advance decision, ReSPECT form or power of attorney affected care, and what you would now do differently; and the specific changes you will make to how you discuss, record or share these decisions. The reflection is stored on your own device and is not sent to us.

The assessment has 15 scenario-based multiple-choice questions. The pass mark is 12 out of 15 (80%). If you fall short, you revisit the sections linked to the questions you missed and try again. On passing you receive a certificate of completion from Healthcare Practise UK.

For CPD, record the time you actually spend, which may be more or less than the two-hour estimate. Nurses, midwives and nursing associates should note that self-directed online learning usually counts towards the NMC's individual CPD hours rather than its participatory hours, unless you complete it with colleagues. Doctors reflect on CPD at appraisal; the GMC does not set a fixed number of hours. The HCPC, GDC, GPhC, GOC, GOsC and GCC each set their own CPD rules, so check what applies to you, and keep your certificate and reflection together.

Most people take this course for one of three reasons. Some want a structured refresher on the law before they start in a role with more end of life decisions, such as a move to a care home, a medical ward or community nursing. Some are preparing for appraisal or revalidation and want a reflection grounded in a real case. Others have been involved in a complaint or a significant event about resuscitation or end of life care and want to show that they have reviewed what the law and guidance expect.

It also works well for teams. A practice or care home can ask every clinician to complete it, then use the quick-reference table, which covers refusals, DNACPR, advance decisions, attorneys and disagreement with families, as the basis for a team discussion. Our team credits for organisations let a manager assign the course and track completion. The course supports awareness and reflective learning. It does not replace any end of life, resuscitation or ReSPECT training your employer requires, so check local requirements.

End of life decisions often depend on capacity, and sometimes on mental health law. The Mental Capacity Act and DoLS course goes deeper into assessing capacity, best interests and deprivation of liberty, and the Mental Health Act essentials course helps non-specialists choose the right legal framework in a crisis. If you work with families and children, the children's consent and confidentiality course covers parental responsibility and Gillick competence. All of these sit in our clinical ethics and law courses. Not sure which course fits your situation? Try the course finder.