Advance Health Care Directive

Explanatory Notes

Every competent adult has the legal right to accept or refuse any recommended health care. This is relatively easy when people are well and can speak for themselves.

Unfortunately, during severe illness people are often unconscious or otherwise unable to communicate their wishes – at the very time when many critical decisions need to be made.

By completing an Advance Health Care Directive, you can make your wishes known before this happens.

What is an Advance Health Care Directive

An Advance Health Care Directive is a document that states your wishes or directions regarding your future health care for various medical conditions. It comes into effect only if you are unable to make your own decisions.

You may wish your directive to apply at any time when you are unable to decide for yourself, or you may want it to apply only if you are terminally ill.

Can anyone make an Advance Health Care Directive? 

Yes, anyone who is over eighteen years of age and is capable of understanding the nature of their directions and foreseeing the effects of those directions can generally make an Advance Health Care Directive.

What do I need to consider before I make an Advance Health Care Directive?

You should think clearly about what you want your medical treatment to achieve if you become ill. For example;

  • If treatment could prolong your life, what level of quality of life would be acceptable to you?
  • How important is it to you to be able to communicate with friends and family?
  • How will you know what technology is available for use in certain conditions?

It is strongly recommended that you discuss this form with your doctor before completing it. The purpose of an Advance Health Care Directive is to give you confidence that your wishes regarding health care are will be carried out if you cannot speak for yourself. However, a resquest for euthanasia would not be followed, as this would be in breach of the law. It is a criminal offence to accelerate the death of another person by an act or omission. It is also an offence to assist another person to commit suicide.

Can I cover all possible health-care decisions in this form?

No, it would not be possible to anticipate everything. However, if you wish, you can appoint someone to have Enduring Guardianship for you; this person can then make decisions on your behalf about your health-care and other personal matters if you are no longer able to do so.

If you have already given someone Enduring Guardianship, all you need to do is discuss this directive with that person.

If you have not yet appointed anyone and you wish to do so, you will need to complete an Appointment of Enduring Guardian form and have a lawyer or a registrar of the local court witness you, and your Enduring Guardian, signing the form. (NOTE: the signatures can be witnessed by different witnesses at different times).

You may also wish to give someone Enduring Power of Attorney for financial matters in case you need someone to manage your property or money, e.g. if you are in a nursing home. If you wish to do that, you will need to complete a separate Enduring power of Attorney form.

Can I change or revoke my Advance Health Care Directive?

Yes, your wishes as stated in an Advance Health Care Directive are not final; you can change them at any time while you remain mentally capable of doing so. It is wise to review your directive every two years or if your health changes significantly. If you do want to make major changes to your directive, you should destroy the current one and make a new one. If you make minor changes, make sure you sign and date alongside the change.

You may also totally revoke your directive at any time. This should be done in writing, so that you can give a copy to anyone who has a copy of your current Advance health Care Directive, but no specific form is required and the person witnessing your signature does not need to be a justice of the peace or a lawyer.

Where can I get help with my Advance Health Care Directive?

As your doctor should complete Section 7 of the document, you could ask him/her to help you. Your doctor could explain any medical terms or other words that you are unclear about. You may also wish to discuss your decisions with family members or close friends.

Who is involved in completing this document?

At least three people:

  1. You, as the principal. (You are referred to as the principal because you are the person principally involved.) You complete Sections 1 to 6 and Section 9.
  2. A doctor who completes Section 7 (you also sign that section)
  3. Your witness who completes Section 10. Your witness should be a justice of the peace or a lawyer. He/She should not be your Enduring Guardian, a relation of yours or of your Enduring Guardian, a beneficiary under your will, your current paid carer or your current health-care provider (e.g. nurse or doctor). Your witness and the doctor who signs Section 7 do not have to sign the document on the same date, but your doctor should sign it first

Note:Paid Carer’ does not mean someone receiving a carer’s pension or similar benefit, so you are free to choose someone who is receiving such a benefit for looking after you.

What do I do with the completed document?

You should keep it in a safe place, and you should give a copy to your own doctor, to your Enduring Guardian if you have appointed one, to a family member or friend and, if you wish, to your solicitor. If you are admitted to hospital or to a residential aged care facility (RACF – previously called a hostel or a nursing home), make sure the hospital or RACF staff know that you have an Advance Health Care Directive and either give them a copy of it or tell them where a copy can be obtained. You may also wish to carry a card in your purse or wallet stating that you have made a Directive, and where it can be found.

How often should I update my Advance Health Care Directive?

It is strongly recommended that you review the document every two years, or if/when there is a major change in your health status (e.g. if you are diagnosed with a serious illness or if you are admitted to a RACF). If you do not wish to make any changes, simply sign and date one part of Section 11. If you do want to make major changes, you will need to complete a new document.

Definition of Terms – Advanced Health Care Directive:

Terminal – resulting in death – the patient can reasonably be expected to die within the next 12 months and this prognosis has been confirmed by a second medical practitioner.

Incurable – no known cure

Irreversible – unable to be turned around – there is no possibility that the patient will recover.

Permanent Unconsciousness – when brain damage is so severe that there is little or no possiblity that the patient will regain consciousness.

Persistent Vegetative State – severe and irreversible brain damage, but vital functions of the body continue.

Palliative Care – treatment that is not aimed at a cure but at caring for the patient by keeping him/her as physically comfortable and pain-free as possible.