A British national living in France may expect a registered health and welfare Lasting Power of Attorney (LPA) to speak for them in every medical setting. That assumption can fail at the hospital door. An LPA made in England or Wales is a UK legal instrument. French healthcare law uses different mechanisms: the patient’s own consent, a personne de confiance (trusted person), directives anticipées (advance directives), and, in a different setting, a French mandat de protection future (future protection mandate). A hospital may therefore ask for more than the UK document, particularly when the patient cannot communicate, when treatment is serious, or when a relative asks for confidential information.

This does not mean that an English or Welsh LPA is worthless in France. It is important evidence of the patient’s wishes and of the attorney’s appointment. It may also contain instructions that are highly relevant to treatment. The practical issue is whether the hospital can verify its scope, its registration, its translation and the circumstances in which the attorney may act under French law. The answer is different in an emergency, for ordinary treatment, for end-of-life decisions and for access to medical records. This article explains the distinction and gives a document-first route for a British patient or family member whose LPA is refused. It is written for England and Wales; Scotland and Northern Ireland use different power-of-attorney systems.

I. Can a French hospital treat a UK health and welfare LPA as authority?

A. What does a UK health and welfare LPA authorise after Brexit?

An LPA is created under the law of England and Wales. A health and welfare LPA allows the donor to appoint one or more attorneys to make personal welfare decisions if the donor cannot make those decisions for themselves. The official UK guidance distinguishes it from a property and financial affairs LPA. A health and welfare attorney may be involved in choices about care, daily routine, medical treatment and where the donor should live, but the instrument must be registered before it can be used. The practical starting point is the complete registered LPA, not a letter from a family member saying that an LPA exists. The official overview is on GOV.UK’s power of attorney page.

The wording matters. The donor may give instructions, record preferences or limit the attorney’s role. The LPA can also state whether the attorney has authority to give or refuse consent to life-sustaining treatment. That choice is not a minor administrative detail. A French doctor reviewing a copy of the LPA needs to see the relevant pages, the registration information, any continuation pages and any restrictions. Sending only the first page, an unregistered draft, or a bank-related LPA can produce a legitimate refusal even when the family believes the attorney has broad authority.

The attorney’s authority is also conditional in England and Wales. A health and welfare attorney generally acts only when the donor lacks the mental capacity to make the particular decision. If the donor can understand, retain, weigh and communicate the relevant information, the donor remains the decision-maker. The UK guidance on health and welfare attorneys explains that the attorney acts when the donor lacks capacity and must act in the donor’s best interests. A French hospital will still assess the patient’s current ability to understand and express a choice under French healthcare law. An attorney cannot use an LPA to silence a patient who is presently capable of deciding.

There is a second limit: the LPA is not itself a French personne de confiance. The French expression means a person chosen by an adult patient to be consulted and to report the patient’s wishes when the patient can no longer express them. It is a statutory healthcare role. A UK attorney may be the ideal person to fill that practical role, but the appointment does not automatically prove that the person has been designated under the French form or recorded in the French medical file. The hospital may therefore ask the patient to complete a French designation as well as producing the LPA.

The same distinction applies to an English advance decision. An advance decision may be powerful evidence of a person’s wishes under the law of England and Wales, and a registered LPA may contain instructions about treatment. France has its own concept of directives anticipées, which concerns the patient’s wishes about continuation, limitation, withdrawal or refusal of medical treatment if the patient later cannot express them. The two instruments should be placed side by side, translated where necessary and analysed for consistency. A hospital should not be asked to guess whether a sentence in an English document is an instruction, a preference, an appointment or a choice about life-sustaining treatment.

Brexit makes the administrative task more important. A British document no longer arrives in a setting where staff can assume that an EU-facing form, a familiar language and an established local record will answer every question. That is a practical consequence of the change in the relationship between the United Kingdom and France, not a conclusion that every UK document has no effect in France. The correct approach is evidence and compatibility: establish who signed the document, who registered it, what decisions it covers, when the attorney may act, and how the document can be relied on in the French clinical setting.

For a patient from England or Wales, the minimum UK evidence normally includes the registered LPA or a certified copy accepted by the Office of the Public Guardian, the donor’s identity document, the attorney’s identity document, the registration details, and every continuation sheet. If the LPA was revoked, replaced or suspended, that history must be disclosed. A hospital that discovers an earlier document or an unclear signature may pause recognition while it verifies the position. Concealing an adverse document can destroy trust at the moment when cooperation is most needed.

Translation is not a cosmetic exercise. The hospital must understand the powers and restrictions in the document, not merely the title. A complete French translation by a qualified translator is usually more useful than a family member’s informal summary. Keep the original English document with the translation. A translator cannot give the document French legal effect, and a translation cannot expand the power actually granted. It should reproduce dates, names, registration references, signatures, schedules and defined expressions accurately.

An apostille may also arise. An apostille is an official certificate used to authenticate the origin of a public document for use abroad; it does not turn every statement in the document into a French legal act. Whether it is required depends on the document, its issuer and what the recipient is being asked to do. The French diplomatic guidance on foreign documents and the notarial guidance on a power of attorney abroad should be checked for the particular document. The safe request to a hospital is not “the apostille proves everything”, but “please identify the formal defect that prevents you from considering this document, so that it can be corrected or explained”.

That point is supported by a useful, but fact-specific, decision. In First Civil Chamber, 14 April 2016, appeal no. 15-18.157, the Cour de cassation examined an Australian notary public’s power used in a French mortgage transaction. The court upheld the conclusion that the foreign form was not equivalent to the French formalities for that authentic act. The decision does not decide the recognition of an English health and welfare LPA in a French hospital. It does show why an apostille, standing alone, cannot answer every question about substance, form, capacity or the protection required by the French transaction. Use it as a warning about proof, not as a blanket rule of invalidity.

The regional origin of the LPA must also be checked. “UK LPA” is often used loosely, but the English and Welsh LPA system is not the Scottish welfare power of attorney system and is not the Northern Irish enduring power system. A patient who signed in Edinburgh or Belfast should not present the document as an England and Wales LPA without obtaining advice on the correct instrument. The hospital needs the governing jurisdiction and the legal status of the document before it can decide what weight to give it.

Finally, an attorney’s role is not a licence to demand unrestricted information from every department. Confidentiality, consent, the patient’s wishes and the proof of authority remain relevant. A request may concern treatment decisions, a copy of the medical record, an insurance form, discharge arrangements or a financial matter. These are not interchangeable. The request should state exactly what information or decision is sought and why the LPA covers it.

B. What does French law require for consent, a trusted person and advance directives?

At the date of publication, the current French framework must be read in the version in force from 28 May 2026. The central provision is Article L. 1111-4 of the Code de la santé publique (French Public Health Code). It begins with the patient’s participation: “Toute personne prend, avec le professionnel de santé … les décisions concernant sa santé.” In English, the person makes health decisions together with the healthcare professional, taking account of the information and recommendations provided. The wording matters for a British patient because the default is not that a relative, attorney or hospital administrator decides instead of the patient.

The same article states: “Aucun acte médical ni aucun traitement ne peut être pratiqué sans le consentement libre et éclairé de la personne.” The quotation means that a medical act or treatment requires the person’s free and informed consent. Consent may be withdrawn. Where the patient cannot express a will, the article directs the doctor, subject to an emergency or impossibility, to consult the French personne de confiance, then the family or, if necessary, a close person. “Consult” is the key word. It does not convert every person consulted into a general attorney with power to authorise any treatment.

There is a separate rule where the adult is already subject to a French legal protection measure involving representation in personal matters. Article L. 1111-4 contains specific rules for obtaining the protected person’s consent when they can express a choice and for the representative’s authorisation when they cannot, with a judicial route for disagreement outside an emergency. A UK LPA is not the same thing as a French court-ordered protection measure. The hospital should therefore be told whether any French measure exists, rather than being asked to infer one from the title “attorney”.

The role of the trusted person is defined in Article L. 1111-6 of the Code de la santé publique. An adult may choose a parent, close person or treating doctor. The trusted person is consulted if the patient is unable to express their wishes and receive the necessary information. The text provides that the trusted person reports the patient’s will and that “Son témoignage prévaut sur tout autre témoignage.” The testimony therefore has priority over other testimony about the patient’s wishes, but the role remains tied to reporting those wishes and the clinical process.

French law requires the designation to be written and co-signed by the person designated. It has no fixed time limit unless the patient or trusted person provides otherwise, and it can be revised or revoked at any time. On admission to hospital, the patient should be offered the opportunity to make the designation. A British patient with capacity can often reduce the dispute immediately by completing the French designation, naming the same person as the UK attorney if appropriate, and asking the admissions team to place it in the medical file. A French form does not cancel the LPA; it gives the hospital a familiar healthcare record for the consultation role.

Do not confuse a trusted person with a next of kin, emergency contact or person who pays the bills. A contact may receive a telephone call without having a role in expressing the patient’s wishes. A next of kin may be consulted where no trusted person is available, but that does not create a universal power to consent. An attorney may have broader duties under English and Welsh law, but the French hospital will still need to identify which part of the request concerns the patient’s clinical wishes, which part concerns disclosure and which part concerns representation.

French advance directives are governed by Article L. 1111-11 of the Code de la santé publique. An adult may write them for the situation in which they later cannot express their will. They concern the conditions for continuing, limiting, stopping or refusing treatment or medical acts, especially in relation to the end of life. The current article says that they are revisable and revocable “À tout moment et par tout moyen”. It also states that the doctor must follow them, subject to a vital emergency needed to assess the situation and where the directions appear manifestly inappropriate or not conforming to the medical situation.

The latest directive prevails if several versions exist, regardless of their medium. A British family should therefore send the current French directive, any English advance decision, the LPA and any later written expression together, with dates. A short handwritten note from the patient may be clinically important even though it is not a French advance directive in the statutory sense. It should be labelled as evidence of current wishes rather than presented under a misleading French legal title.

Medical secrecy adds another layer. Article L. 1110-4 of the Code de la santé publique protects private life and the confidentiality of information concerning a person receiving care. A hospital may therefore insist on proof before emailing a full medical file to an attorney in the United Kingdom. The confidentiality rule does not mean the patient’s chosen representative can never receive information. It means that the hospital must identify the lawful basis, the scope of the consent or authority, and the information strictly needed for care or the particular request.

The patient’s own access rights should be used constructively. Article L. 1111-7 of the Code de la santé publique gives a person access to the health information held by healthcare professionals and establishments, including consultation, intervention and hospitalisation records. The current text also addresses access where an adult is subject to a French protection measure involving representation. A UK attorney should ask the hospital to state whether it refuses access because the LPA is not accepted, because the patient’s consent is missing, or because a particular document contains information from a third party. A precise reason allows a precise correction.

Communication must not be mistaken for incapacity. Since 28 May 2026, Article L. 1111-6-2 of the Code de la santé publique provides that, where an adult is partly or wholly unable to express themselves, alternative and augmentative communication should be put in place to seek informed consent. The text states that, where possible, non-verbal means have the same legal value as direct verbal expression when assessing the person’s wishes. For a British patient, this supports asking for an interpreter, written English information, a communication board or an appropriate device where needed. It does not by itself appoint the attorney or remove the need to assess the patient’s wishes.

The Civil Code supplies a related autonomy principle. Article 415 of the Code civil sets the protective framework for adults: the protection must respect the person’s freedoms, fundamental rights and dignity and promote their autonomy. Article 425 of the Code civil concerns a person who cannot look after their interests alone because of a medically established impairment affecting mental faculties or bodily faculties in a way that prevents expression of their will. These provisions help explain why a French doctor will ask both “can this patient decide now?” and “what reliable evidence shows what the patient wanted?”

In a clinical emergency, the sequence changes. Article L. 1111-4 expressly refers to consultation subject to “sauf urgence ou impossibilité”. If a British patient has severe symptoms, call 15 or 112 or go to the nearest emergency department. Take the LPA if it is available, but do not delay urgent treatment while a family member argues about apostilles. The document dispute can be recorded and escalated after the immediate clinical assessment. The Service Public guidance on patients’ rights during hospitalisation also provides a practical route for understanding patient rights and complaints.

II. How can a British patient challenge the refusal and secure care in France?

A. What should you send to the hospital immediately?

The first objective is to turn a general refusal into an identifiable issue. Ask the hospital in writing: “Are you refusing the treatment, refusing to consult the named person, refusing to disclose information, or refusing to recognise the LPA as a document?” These are four different problems. A doctor may be willing to treat but unable to disclose details to a person whose authority is unverified. An admissions office may reject an incomplete translation even though the medical team would consider a complete copy. A written question prevents each department from assuming that another department has dealt with the issue.

Send one organised bundle, with a short cover letter in English and, where possible, French. The cover letter should state the patient’s full name, date of birth, hospital number, current location, the date and nature of the refusal, the urgency, the attorney’s contact details and the exact decision requested. Avoid a long family history. A doctor needs a reliable map of the legal documents, not a chain of emotional messages.

The core bundle should contain the following documents:

• the complete registered health and welfare LPA for England and Wales, including continuation pages, attorney details, instructions, preferences and the life-sustaining-treatment choice;
• the registration evidence and any later notice of revocation, replacement, suspension or objection;
• the donor’s identity document and the attorney’s identity document, with names matched to the LPA;
• a complete French translation prepared by a qualified translator, placed next to the English original rather than replacing it;
• a brief clinical document explaining whether the patient currently lacks capacity for the particular decision, without sending irrelevant sensitive material;
• any French written and co-signed designation of a personne de confiance;
• the patient’s French directives anticipées, if one exists, and any English advance decision or later written statement of wishes;
• the patient’s signed request for information or consent to disclosure if the patient can still give it; and
• the contact details of the attorney, a family contact, the UK legal adviser dealing with the LPA and the French lawyer or notary assisting with the cross-border issue.

Ask the hospital to confirm whether it requires an apostille, legalisation, a certified translation or a particular certification of the copy. Legalisation and apostille are formal processes that address the origin of a signature or public document; they do not decide whether the underlying appointment gives the requested power in France. The French diplomatic information on notarial documents abroad and the notaries’ guidance on making a power of attorney abroad are useful starting points, but the receiving hospital’s precise requirement still needs to be recorded.

If the hospital says that there is no French trusted-person designation, deal with that point separately. If the patient has capacity, ask the hospital to provide its written form or use the official Service Public information and form for designating a trusted person in healthcare. The patient should complete it, and the person designated should co-sign it. Ask for confirmation that the document has been placed in the medical file and that the named person will be consulted if the patient later cannot express their wishes. This can remove a practical obstacle without pretending that the French designation is a translation of the entire LPA.

If the patient cannot speak easily, ask the medical team to distinguish an inability to speak French from an inability to express a will. A language barrier is not the same as incapacity. Request an interpreter or written information in English, allow sufficient time, and ask the team to record how the patient communicated. Where the patient has a speech, neurological or cognitive difficulty, refer to the new communication rule in Article L. 1111-6-2. A communication tool may help the patient express a direct choice; it does not make the attorney’s view the patient’s view.

Ask for the clinician’s reason if treatment is refused or delayed. The question should cover the medical reason, the legal reason and the administrative reason. If the answer is that the patient’s wishes are unclear, provide the dated documents in chronological order. If the answer is that the LPA has no French equivalent, ask whether the team will nevertheless consider it as evidence of wishes, whether a French trusted-person form would resolve the issue, and whether the hospital’s legal department can review the translation. If the answer is confidentiality, ask what limited information can be shared to coordinate care and what proof would permit wider disclosure.

Keep an evidence log. Record the date, time, department, name and role of each person contacted, the exact document supplied, the reason given for refusal and the next step promised. Save emails, portal messages, letters, photographs of forms and delivery confirmations. Do not secretly record a clinical meeting without checking the legal and practical consequences. A contemporaneous written log is usually more useful than a later recollection of a stressful conversation.

Use the hospital’s internal route while preserving the medical route. Ask for the department head, the hospital’s patient-relations contact, the medical mediator or complaints mediator identified by the institution, and, where applicable, the commission des usagers (users’ commission). The Service Public hospital-rights page identifies complaint and assistance routes. Explain that the issue concerns the patient’s access to care and expression of wishes, not simply a disagreement between relatives. If the hospital is private, ask which complaints body and contractual route apply. If it is public, ask for the institution’s written procedure and the name of the responsible contact.

Request a copy of the relevant medical record under Article L. 1111-7 where the patient can make the request or where a valid representative can do so. The request should be limited to records needed to understand the refusal, treatment decision or capacity assessment. A request for every record since birth can slow the immediate issue. Ask for the medical note that records the patient’s capacity, the consultation of relatives or trusted person, the treatment proposal and the reason for any refusal. The request can also identify the attorney and attach the LPA for review.

The 2016 decision in appeal no. 15-18.157 should be cited carefully if the hospital says that an apostille proves the foreign document’s legal effect. Its conclusion concerned an Australian notary’s power used for a French mortgage, and the court found the foreign form was not equivalent to the French formalities in that transaction. It is not authority for a hospital to ignore a UK healthcare document. It is a precise reminder that the receiving professional may examine the legal function of the document, its formal requirements and the protection involved. Ask for the hospital’s specific objection rather than arguing from the word “apostille”.

B. What legal escalation is available if the refusal continues?

If the hospital continues to reject the LPA after receiving a complete bundle, obtain advice from a French lawyer who can work with the patient’s England and Wales adviser. The first question is not “which country wins?” It is “what decision is blocked, by whom, and on what legal basis?” The answer determines whether the next step is a corrected translation, a French trusted-person designation, a medical complaint, a request for records, an application relating to protection of an adult, or urgent proceedings concerning a public or private establishment.

A French mandat de protection future may be relevant for a person who wants to organise protection in France, but it is not an instant hospital consent card. Article 477 of the Civil Code allows an adult who is not already under certain French protection measures to appoint one or more persons to represent them if they later cannot look after their interests alone. Read the current text in Article 477 of the Code civil. The French mandate must be drafted in a form permitted by French law and its powers must be understood; it does not automatically replace a UK LPA for every purpose.

Activation is also formal. Under Article 481 of the Code civil, the mandate takes effect when it is established that the person can no longer look after their interests alone. The mandataire produces the mandate and a medical certificate from a doctor selected from the list referred to in Article 431 at the registry of the judicial court; the clerk dates and endorses its effect. That process takes time and evidence. It is a planning option for a person settling in France, not a substitute for emergency treatment or a way to postpone a necessary clinical decision.

The official Service Public explanation of the future protection mandate should be read with the Civil Code. It explains who can make the mandate, how it can be established and how it is implemented. A British resident should ask a French notary or lawyer whether a French mandate would complement the existing LPA, whether the intended attorney can act, and whether the document would cover personal matters or only property. A French mandate should be drafted for the patient’s actual life in France, not copied blindly from a UK form.

French case law shows why implementation and the patient’s interests matter. In First Civil Chamber, 4 January 2017, appeal no. 15-28.669, the Cour de cassation held, in the context of a French future protection mandate and a later curatorship, that “seul le mandat de protection future mis à exécution prend fin par le placement en curatelle”. The case does not recognise or reject a UK LPA. Its practical lesson is that one must identify whether a French mandate has actually been implemented and how a later judicial measure affects it. A document that was signed but never activated cannot be presented as an active French representative’s authority.

If a French judicial protection application becomes necessary, medical evidence and procedure are not optional details. In First Civil Chamber, 2 March 2022, appeal no. 20-19.767, the Cour de cassation examined the procedural requirements around changing a curatorship and the medical certificate required for a protection application. That decision concerned a French protection measure, not a hospital’s treatment of a UK LPA. It nevertheless illustrates why a family should not ask a hospital to create a de facto protection order by accepting an informal letter. The correct judicial route and medical certificate must be considered if the patient’s welfare cannot otherwise be protected.

A dispute about a treatment decision may also raise a different issue from a dispute about documents. If the patient is capable, the direct choice must be addressed. If the patient lacks capacity, the clinician must apply the French rules on consultation, advance directives, any applicable French protection measure and the patient’s known wishes. If a doctor rejects advance directives as manifestly inappropriate or non-conforming to the medical situation, Article L. 1111-11 requires the decision to follow the applicable collegial process and to be recorded. The attorney should ask for that reasoning in writing rather than asserting that the LPA permits a private veto over the doctor’s clinical assessment.

For a public hospital, urgent advice may need to assess an administrative-law route; for a private hospital, the analysis may concern the care contract, professional liability, internal complaints and civil proceedings. A French lawyer can identify the appropriate court and urgency procedure after reviewing the refusal, the medical risk and the status of the establishment. Do not file a generic threat copied from English proceedings. A letter should state the treatment or information sought, the documents proving the patient’s wishes, the defect identified by the hospital and the action requested by a realistic deadline.

If the blocked issue is access to records, keep the request under Article L. 1111-7 separate from the treatment dispute. If the blocked issue is confidentiality, ask for a limited release or an appointment with the doctor. If the blocked issue is a missing French trusted-person form, complete it while the LPA is reviewed. If the blocked issue is a translation, correct the translation and supply a glossary for recurring expressions such as “best interests”, “life-sustaining treatment”, “advance decision” and “capacity”. A sequence of small corrections is often faster and safer than insisting that one document must perform four different legal functions.

The UK side may still require action. If the LPA’s registration, revocation, attorney appointment or authority for life-sustaining treatment is disputed, contact the Office of the Public Guardian or an England and Wales adviser. The official LP12 guidance explains the form, instructions, preferences and life-sustaining-treatment option. A French hospital cannot adjudicate every dispute about the validity of an English instrument, and an English adviser cannot decide how French clinical confidentiality works. The two legal analyses must run together.

Where the patient is moving permanently to France, plan before the next admission. Tell the French general practitioner about the LPA, provide a translated copy, complete the French trusted-person designation, discuss French advance directives and place the documents where the patient and attorney can retrieve them. Give the attorney permission to share the minimum necessary information with the French care team. Keep a one-page emergency summary with the patient’s language, communication needs, allergies, diagnosis, wishes and document locations. Planning does not guarantee that a French hospital will accept every foreign instrument without review, but it removes the avoidable uncertainty that turns an admission into a legal dispute.

Paris and Île-de-France patients should add the hospital’s exact site and department to the emergency summary. Large hospitals may have separate admissions, emergency, intensive-care, legal, patient-relations and medical-record teams. Ask for a single contact to coordinate the LPA review and send each new document through that channel. If the patient is transferred between hospitals, carry the complete bundle and obtain confirmation that the new team has received it. A document accepted in one hospital is not a universal French registration, so keep the evidence available at each transfer.

Conclusion

A UK health and welfare LPA can be valuable evidence for a British patient in France, but its title does not automatically make it a French healthcare mandate. The patient’s current consent remains central. If the patient cannot express a will, French law directs the medical team towards the personne de confiance, family or close person, the patient’s advance directives and the applicable rules for emergencies and protected adults. The attorney should present the LPA as part of a complete, translated and dated evidence bundle, while also completing a French trusted-person designation and French advance directives wherever possible.

If a hospital refuses the document, ask what exactly is refused: treatment, consultation, disclosure, or recognition of authority. Record the answer, obtain the clinical reason, request the relevant medical record, use the hospital’s complaints route and seek coordinated advice from a French lawyer and an England and Wales adviser. A French future protection mandate may help with longer-term planning, but it is not a substitute for urgent care. The quickest resolution usually comes from matching the document to the decision, proving the patient’s wishes and correcting the precise formal defect identified by the hospital.

Need a quick opinion on your case

If a French hospital, care provider or family member is refusing to recognise your UK health and welfare LPA, you can arrange a telephone consultation within 48 hours with a lawyer from the firm.

Call +33 6 46 60 58 22 or use the contact form for the firm. Advice can cover France-wide issues, including Paris and Île-de-France, and the coordination of French and England-and-Wales documents.