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Background: an anticipatory decision document records a person's wishes regarding medical treatment at a time when they have capacity to make choices, to be enacted when this capacity is lost. In England and Wales an advance decision to refuse treatment (ADRT, or advance decision), a legally binding document, is currently rarely used. A disparity is suggested to exist between physicians’ support for anticipatory decisions in principle and their lack of impact on decision-making in practice.

Objective: to elicit geriatricians’ views on advance decisions and their use in decision-making in England.

Design: a qualitative approach was taken. Semi-structured interviews were conducted with 10 geriatricians. An inductive approach was used for data analysis.

Results: geriatricians held positive views on anticipatory decisions in principle. In practice, they reported being highly …