I don't think there is much point to it, but I think (you had better check) that you can absolutely rule out ECT and neurosurgery regardless of the MHA . . . Also, it might have guiding force. If you said you didn't want a very specific medication, they're not bound to follow it (i.e., you can't sue if they don't), but they might take it as persuasive. I filed one with my psych against clozapine and he wasn't really keen on it, but he did put it in my file -- so hopefully they'll pay attention if they ever decide to assault and wrongfully imprison me again!

Also, NHS record-keeping is shite (some of my records say I'm five years older than I am ) and I have no idea how they EVER monitor advance directives.