Living Will (Nigeria)

A Living Will in Nigeria records a person's wishes about future medical treatment for use if they later lose capacity to decide, grounded in the National Health Act 2014 and the common-law right to refuse treatment. It allows a competent adult to set out treatment preferences and refusals in advance.

The legal framework for Living Wills in Nigeria is derived from the National Health Act 2014 (NHA 2014), which establishes patients' rights including the right to participate in decisions affecting their health under Section 23 of the Act. The NHA 2014 recognises the principle of informed consent — Section 23(2) provides that a healthcare provider must obtain the informed consent of a patient or user before treating them, and Section 23(3) recognises that a person may refuse consent to treatment. These provisions form the statutory foundation for advance directives.

The Mental Health Act 2021 (which repealed the Lunacy Act 1916) further recognises the rights of persons with mental health conditions to be involved in decisions about their care and treatment, and supports the concept of advance decisions made while the person had capacity. The Nigerian Medical and Dental Council (MDCN) Code of Medical Ethics also acknowledges patient autonomy and the right to refuse treatment.

A Living Will must be distinguished from an Enduring Power of Attorney for healthcare decisions (a Healthcare Proxy), by which a person appoints another individual to make medical decisions on their behalf if incapacitated. The Living Will states the person's own wishes; the Healthcare Proxy designates a decision-maker. Both instruments are complementary and are recommended to be executed together for thorough advance care planning. In Nigeria, both documents are most relevant in the context of end-of-life care in public and private hospitals including Lagos University Teaching Hospital (LUTH), National Hospital Abuja, and the University of Nigeria Teaching Hospital (UNTH), Enugu.

The Living Will (Nigeria) draws on a healthcare-specific legal framework rather than commercial statutes. Section 23 of the National Health Act 2014 establishes informed consent and the right of a competent adult to refuse treatment, while the Mental Health Act 2021 recognises advance decisions made while a person had capacity. The Nigeria Data Protection Act 2023 (NDPA), administered by the Nigeria Data Protection Commission (NDPC), governs the health data recorded in the directive, and the Child Rights Act 2003 applies where a minor is involved. The Medical and Dental Council of Nigeria (MDCN) Code of Medical Ethics binds the treating practitioners who must give effect to the document. A person executing a Living Will should confirm the directive reflects current law and have it witnessed in accordance with the National Health Act 2014. The National Health Act 2014 sets the foundational requirements.

A Living Will in Nigeria is needed whenever an adult wishes to record their medical treatment preferences for situations where they may lose the ability to communicate or make decisions.

A Living Will is needed when an adult is diagnosed with a serious or terminal illness — such as advanced cancer, severe heart disease, end-stage renal failure, or a progressive neurological condition such as Parkinson's disease or motor neurone disease — and wishes to direct their treating physicians at their hospital (whether a public teaching hospital or a private hospital registered with the Corporate Affairs Commission under CAMA 2020) regarding the extent of medical intervention they wish to receive.

A Living Will is required when an adult undergoes major surgery with significant risk of post-operative incapacity or permanent loss of consciousness, and wishes to establish in advance whether they consent to mechanical ventilation, cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, or other life-sustaining treatments if they become unable to consent during or after the procedure.

A Living Will is needed when an elderly person is admitted to a nursing home, care facility, or long-term care ward and wishes to confirm that their end-of-life treatment preferences are respected by care staff, consistent with the rights of patients under the National Health Act 2014 and the MDCN Code of Ethics for medical practitioners in Nigeria.

A Living Will is needed by a person who has strong religious or ethical convictions about specific medical treatments — such as blood transfusions, certain surgical procedures, or artificial life support — and wishes to confirm those convictions are respected by healthcare providers if the person becomes unconscious or loses decision-making capacity.

An individual in Nigeria should prepare a Living Will while they still have full mental capacity rather than waiting until a health crisis removes the chance to decide. Healthcare providers act on the written directive and the patient's documented wishes rather than the assumptions of relatives. Section 23 of the National Health Act 2014 secures the right of a competent adult to consent to or refuse treatment, the Mental Health Act 2021 supports advance decisions, and the MDCN Code of Medical Ethics obliges practitioners to respect a clearly expressed refusal. Where the directive addresses organ or tissue donation, Part V of the National Health Act 2014 applies.

A valid Living Will in Nigeria must contain the following essential elements.

Declarant Identification: Full legal name, date of birth, address, and National Identification Number (NIN) from the National Identity Management Commission (NIMC) of the person making the directive. The declarant must be an adult (18 years of age or older) of sound mind and full legal capacity at the time of execution.

Statement of Capacity: A declaration that the declarant is of sound mind, understands the nature and effect of the document, and is executing it freely and voluntarily.

Medical Treatment Directives: Specific instructions regarding the treatments the declarant does and does not wish to receive if they become terminally ill, permanently unconscious, or otherwise unable to make decisions. Directives may address: cardiopulmonary resuscitation (CPR); mechanical ventilation and breathing machines; artificial nutrition and hydration (tube feeding and IV fluids); kidney dialysis; antibiotics and other medications for life-threatening infections; and surgical or invasive procedures.

Healthcare Proxy (Optional): Designation of a trusted person — such as a spouse, adult child, or close friend — as the declarant's healthcare proxy or agent, with authority to make medical decisions consistent with the Living Will's directives if the declarant is incapacitated. The healthcare proxy's full name, address, and contact details should be provided.

Organs and Tissue Donation: Whether the declarant consents to organ or tissue donation on death under the National Health Act 2014 and the relevant medical ethics guidelines of the MDCN.

Revocation: A statement that the declarant may revoke the Living Will at any time while mentally competent, by written notice, oral statement to a healthcare provider, or physical destruction of the document.

Witnesses: Two adult witnesses who are not healthcare providers treating the declarant, not beneficiaries under the declarant's will or trust, and not related to the declarant by blood or marriage, to attest that the declarant signed freely and with capacity.

Additional compliance elements for a Living Will (Nigeria) include alignment with Section 23 of the National Health Act 2014 on informed refusal of treatment, the advance-decision recognition under the Mental Health Act 2021, and protection of the declarant's health data under the Nigeria Data Protection Act 2023. Execution before a Commissioner for Oaths under the Oaths Act (Cap O1, LFN 2004) strengthens the document's evidential weight. Forms-legal.com provides this template as a starting point for Nigeria-compliant documentation.