An Advance Health Directive allows you to record directions about your future health care for a time when you are unable to make those decisions yourself.
It can include directions about life-sustaining treatment if you are nearing the end of your life or are in certain other serious medical circumstances. This can include treatment aimed at keeping you alive or delaying your death, such as CPR or assisted ventilation. Your Advance Health Directive can also include directions about other health care.
An Advance Health Directive gives you an opportunity to consider these decisions in advance and record your wishes about the health care and treatment you would or would not want in particular circumstances.
An Advance Health Directive works alongside an Enduring Power of Attorney. While an attorney may make health decisions for you when you do not have capacity to make those decisions yourself, an Advance Health Directive allows you to record your own directions about particular health care in advance.
Questions about Advance Health Directives
Who can make an Advance Health Directive?
You can make an Advance Health Directive if you are 18 years or older and have capacity to make the document. This includes understanding the nature and effect of the Advance Health Directive and making it freely and voluntarily.
As part of making an Advance Health Directive, you will need to discuss the contents of your Advance Health Directive with a doctor, who will complete the required certificate.
You must then sign your Advance Health Directive in the presence of an eligible witness, such as a lawyer. The witness must certify that, at the time you make the Advance Health Directive, you appear to have capacity to make it, including that you appear to understand the nature and effect of the document and are capable of making it freely and voluntarily.
What can I include in an Advance Health Directive?
An Advance Health Directive allows you to give directions about your future health care for a time when you do not have capacity to make decisions about the particular health matter yourself.
You can give directions about particular treatments or health care that you would or would not want to receive in particular circumstances. You can also record information about your wishes, values and beliefs to help guide decisions about your health care.
An Advance Health Directive can also be used to appoint one or more attorneys for health matters and to give instructions about the exercise of their powers.
When do my directions about life-sustaining treatment apply?
Your directions about life-sustaining treatment only apply if you are unlikely to regain capacity to make your own health care decisions and particular medical circumstances exist.
These include where you have a terminal illness or condition and, in the opinion of two doctors, you are reasonably likely to die within 12 months; where there is no reasonable prospect of recovering to the extent that you can live without life-sustaining treatment; where you are permanently unconscious with no reasonable prospect of regaining consciousness; or where you are in a persistent vegetative state involving severe and irreversible brain damage.
A health provider does not have to follow a direction that is inconsistent with good medical practice or will not benefit you. A direction also does not have to be followed if it is uncertain or circumstances have changed, including because of advances in medicine, to the point that the direction is no longer appropriate.
When does an Advance Health Directive apply?
A direction in your Advance Health Directive operates when you do not have capacity to make a decision about the health matter covered by that direction.
This means that making an Advance Health Directive does not take away your ability to make your own health care decisions while you have capacity to do so.
There are additional requirements that apply to some directions, including directions about withholding or withdrawing life-sustaining measures. Whether a particular direction operates will depend on the circumstances at the time.
Is an Advance Health Directive legally binding?
A valid Advance Health Directive is legally binding when the directions apply to your circumstances.
There are legal requirements about when particular directions will operate, particularly directions about life-sustaining treatment.
What is the difference between an Advance Health Directive and an Enduring Power of Attorney?
An Advance Health Directive and an Enduring Power of Attorney have different roles.
An Advance Health Directive allows you to give directions about your future health care, including directions about life-sustaining treatment in particular circumstances when you are nearing the end of your life and do not have capacity to make the relevant health care decision yourself.
An Enduring Power of Attorney allows you to appoint someone you trust to make decisions for you. This can include personal and health decisions when you do not have capacity to make those decisions yourself, as well as financial decisions depending on the authority you have given them.
An Advance Health Directive can also appoint an attorney for health matters, but its important distinction is that it allows you to give directions in advance about the health care you want or do not want in particular circumstances.
Can I change or revoke my Advance Health Directive?
You can change or revoke your Advance Health Directive while you have capacity to do so.
If your wishes, health or circumstances change, it is important to consider whether your existing Advance Health Directive still reflects what you want. Depending on the changes you want to make, it may be appropriate to make a new Advance Health Directive
If you make a new Advance Health Directive, it is also important to make sure that people and organisations who have a copy are made aware that it has been revoked.
Who should I give a copy of my Advance Health Directive to?
Your original Advance Health Directive should be kept somewhere safe where it can be located if it is needed.
You may wish to give a copy to your doctor, your attorney/s for health matters and other people who may need to know about your health care directions. You may also want to take a copy with you if you are admitted to hospital or another health care facility.
It is important that the people who may need to rely on your Advance Health Directive know that it exists and where it can be found.
How we can help
Making an Advance Health Directive involves thinking carefully about the health care you would or would not want in particular circumstances.
We can help you understand how an Advance Health Directive works, discuss how it fits with your Enduring Power of Attorney and prepare the document to reflect your instructions. You will also need to discuss the contents of your Advance Health Directive with your doctor before the document is completed.
If you already have an Advance Health Directive, we can review it with you and advise whether it continues to reflect your wishes and circumstances.