Ruqayyah Snyder
An advance care directive is a legal document that allows an individual in Australia to outline their preferences for future medical treatment and care in the event they lose the capacity to consent or refuse treatment. This document is sometimes referred to as a living will and can include specific instructions for treatment, as well as general statements about an individual's values and beliefs. It is important to note that advance care directives can vary between states and territories in Australia, and individuals should refer to the specific requirements in their respective region. These directives empower individuals to make decisions about their health care in advance, ensuring their wishes are respected even when they cannot communicate them directly.
| Characteristics | Values |
|---|---|
| Legal status | An Advance Care Directive (ACD) is a written legal document that outlines your future care preferences, values, and beliefs. |
| Purpose | It ensures your wishes are respected and followed if you cannot communicate them yourself. |
| Content | It can include general statements about your values and preferences, as well as specific instructions on consenting to or refusing certain treatments. |
| Appointments | You can appoint a substitute decision-maker, also known as a medical treatment decision-maker, to make decisions on your behalf if you lose decision-making capacity. |
| Revocation | You can revoke or change your Advance Care Directive at any time, and it is important to provide the latest version to your family and health professionals. |
| Age Requirements | Anyone with decision-making capacity can create an Advance Care Directive, including those under 18 and people with disabilities. |
| Forms | Forms and requirements vary between Australian states and territories. Specific forms may be available on state websites or Advance Care Planning Australia. |
| Signing | Your Advance Care Directive should be signed and dated by you and can also be signed by your substitute decision-maker and doctor. It can be signed electronically but must be witnessed in person. |
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What You'll Learn
Substitute decision-makers
In Australia, when a person loses decision-making capacity and hasn't prepared an Advance Care Directive, or their directive doesn't cover a specific situation, a substitute decision-maker may be appointed. This person is responsible for making personal and/or lifestyle decisions on behalf of the individual who lacks capacity.
Each state and territory in Australia has its own legislation regarding substitute decision-makers. Generally, these are the steps that are followed:
Step 1: Identify the Decision-Making Model
There are two models of decision-making: the substitute decision-making model and the supported decision-making model. In the substitute model, the decision-maker acts in place of the individual, whereas in the supported model, the decision-maker assists the individual in making their own decisions.
Step 2: Determine Capacity
Before a substitute decision-maker can be appointed, it must be established that the person in question does not have the capacity to make their own decisions. This assessment is usually made by a medical professional.
Step 3: Identify the Appropriate Decision-Maker
The legislation provides a hierarchy of people who can act as substitute decision-makers. The order of this hierarchy may vary slightly between states, but generally follows this order:
- A person appointed by the individual during their decision-making capacity (via an Advance Care Directive or other legal instrument)
- A spouse or de facto partner
- A carer or close friend
- A family member (typically an adult child or parent)
- A person nominated by the Public Advocate or Guardian (a government official responsible for protecting the rights of vulnerable people)
Step 4: Make Decisions in the Person's Best Interests
When making decisions on behalf of someone else, substitute decision-makers must always act in the person's best interests. This involves considering their current and previous wishes, their values, beliefs, and anything else that is relevant to the decision at hand.
Step 5: Maintain and Review the Plan
It is important to note that substitute decision-makers cannot make decisions about medical treatment. These decisions are made by health professionals in consultation with the person's family and friends, taking into account any relevant Advance Care Directive.
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Values and preferences
An advance care directive is a legally binding document that outlines an individual's values and preferences for their future health care, including end-of-life care. It is a formalised version of an advance care plan, allowing individuals to record their general values, beliefs, goals, and preferences to guide future medical decisions. This ensures that their future healthcare aligns with their values, even if they are unable to make decisions for themselves.
The process of creating an advance care directive involves discussing one's values and preferences with family, friends, carers, and healthcare professionals. These discussions help individuals clarify their values and preferences, and ensure that their loved ones understand their wishes. While these discussions can be challenging, they are an essential aspect of advance care planning.
The advance care directive document can include specific directives about treatments an individual consents to or refuses, often referred to as an 'instructional directive'. It may also include a 'values directive', which describes an individual's views, values, and preferences. These directives guide medical practitioners in making clinical decisions when the individual is incapacitated and unable to communicate their wishes.
It is important to note that advance care directives differ between Australian states and territories, and specific forms may be required. These forms can be found on the Advance Care Planning Australia website, along with resources and information in various languages. Individuals should ensure they are using the correct form for their state or territory and should seek information about the specific requirements and processes.
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Legal requirements
An Advance Care Directive (ACD) is a legally binding document in Australia that outlines an individual's preferences, values, and goals for their future care. It is important to note that the legal requirements and recognition of ACDs vary across different states and territories in Australia. Here are some key legal aspects to consider:
Common Law Advance Care Directives:
Common law Advance Care Directives are recognised by the common law, meaning they are based on decisions made by judges in courts. These directives do not follow a specific format and have no formal requirements other than being made voluntarily by a competent person with decision-making capacity. This includes the capacity to communicate their treatment decisions and make these decisions without undue influence or pressure. Common law ACDs can be made orally or in writing, and they are legally binding in some states and territories but not in others.
Statutory Advance Care Directives:
Statutory Advance Care Directives are legislated state-based directives that outline an individual's care preferences or appoint a substitute decision-maker. All states and territories have legislative provisions allowing the appointment of a substitute decision-maker if an individual loses decision-making capacity. The extent of legislation and the type of statutory directive vary across Australia.
Validity and Recognition:
Valid Advance Care Directives are generally recognised in other states and territories, but there may be limitations and additional requirements depending on the region. It is important to check the specific laws and requirements of your state or territory when creating or updating your ACD.
Instructional Directives and Values Directives:
An Advance Care Directive can include instructional directives, which provide specific instructions about the treatments an individual consents to or refuses. Health practitioners must follow these instructions if the individual loses decision-making capacity. ACDs can also include values directives, which describe an individual's views, values, and preferences to guide future medical treatment decisions.
Substitute Decision-Makers:
You can formally appoint a substitute decision-maker, also known as a medical treatment decision-maker, in your Advance Care Directive. This person will make decisions about your medical treatment if you lose decision-making capacity. It is important to carefully choose someone who will make decisions based on your values and preferences. Some states and territories may have specific forms for appointing a substitute decision-maker.
Witnesses and Signatures:
While not a universal requirement, it is generally recommended that two adult witnesses are present for an Advance Care Directive, with one being a registered medical practitioner. The individual creating the ACD must be satisfied that the witnesses understand each statement in the document. Some states and territories may also allow for electronic signatures or online witnessing.
Changes and Updates:
You can change or revoke your Advance Care Directive at any time. It is important to ensure that anyone who has the original directive receives the updated version, as the most recent version will be the one followed.
It is always advisable to seek legal advice or consult official government sources for the most accurate and up-to-date information regarding the legal requirements of Advance Care Directives in your specific state or territory in Australia.
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Instructional directives
An advance care directive is a legal document that outlines an individual's preferences for future healthcare and medical treatment in Australia. It is a way to ensure your wishes are respected and carried out, even if you are unable to communicate them at the time.
The instructional component of an advance care directive is crucial, as it provides
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Advance care planning
An Advance Care Directive (ACD) is a written advance care plan that formalises your wishes. It is a legal document that outlines your preferences for future care, including your beliefs, values, and goals. It is important to note that ACDs may have different names in different states and territories of Australia.
The process of creating an ACD involves discussing your future health care preferences and may involve documenting them. These discussions can be challenging, but they are essential to ensuring your wishes are respected. During these conversations, it is important to consider the following:
- Your values, beliefs, and preferences for future health and personal care, including specific treatments you consent to or refuse.
- Appointing a medical treatment decision-maker (and an alternative) who will make decisions on your behalf when you cannot. This person should be someone you trust to make decisions based on your values and preferences.
- Appointing a support person to assist you in making, communicating, and giving effect to your medical treatment decisions.
Once you have completed your ACD, you should sign and date it, and have your substitute decision-maker and doctor sign it as well. You can change your ACD at any time, and it is important to keep it up to date. Ensure that anyone you shared the original directive with receives the new version, as only the most recent version will be followed.
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