Advance care planning provides an opportunity for people to think, discuss and plan for the medical treatment they would prefer if they became too ill in the future to express their wishes.
Advance care planning is not euthanasia. It is about people taking control of their health care wishes.
Everyone should consider advance care planning, regardless of their age or health. But, it is particularly important for people who have ongoing health problems.
This is a written document that records the medical treatment wishes of a person, which can then be used if a person is unable to speak for themselves due to illness or injury. The document may also appoint a substitute decision maker and include non-medical wishes for end of life such as spiritual care.
These are only used if a patient or client is unable to make or communicate his or her own decisions. The directive would then be used to guide the decision making of the medical staff, substitute decision maker if one has been nominated, and your family.
Any person over 18 years of age can make an advance care directive, unless they are already unable to make their own decisions about medical treatment due to a disability, illness or injury.
No, the law does not require a lawyer to complete an advance care directive. Your doctor or someone experienced in advance care planning can help you to complete this document.
Yes, ideally you should discuss your advance care directive with your doctor. This means that any decisions you make will be made on the basis of good information.
Your doctor, or any other doctors treating you in the future, will understand that you were informed prior to making your decisions and this will help them to follow your directive with confidence.
Taking part in advance care planning gives people the opportunity to talk to their family and doctor about future medical care. After these discussions, a person's wishes can then be written down and a trusted person nominated to make decisions for you if you are unable to do so yourself in the future.
Having done this often reassures many people and their families as they have a clear idea of what would need to be done in the event of a loved one becoming too ill or injured to speak for themselves.
Your family – Close and loving relationships don't necessarily always mean that loved ones know or understand the wishes of a person in relation to future medical care. These wishes should be talked about with the people who would most likely be involved in making decisions on your behalf.
Your doctor/s – Doctors can help you to understand your current health and what you might need in the future. They can also provide information about the potential outcomes of treatment, which you can then take into account in deciding if you would want some treatments if they meant that you did not return to your previous quality of life. Doctors can also help you to make an advance care directive and then should keep a copy of your directive on file.
People experienced in advance care planning – there are community based health care workers who can help you and, in some hospitals, specialist staff.
Yes, you can nominate a substitute decision-maker everywhere in Australia except the Northern Territory.
There are some differences between Australian states, but generally substitute decision makers can consent to medical treatment on your behalf if you are unable to do so yourself. In some states, they can also legally refuse medical treatment if you have made your wishes in that regard clear in an advance care directive.
Your substitute decision maker is expected to act in your best interests and make the same decisions they believe you would have made yourself.
They should, therefore, be someone who you trust to listen carefully to your wishes for future medical treatment and to then faithfully represent you when you can no longer speak for yourself.
He or she may be required to make difficult decisions in difficult situations so you need to be reassured that they will be able to do so.
Often, these people are family members but they can be any person who you believe can fulfill this role, who is over 18 years of age.
The names and authorities of people in this role can vary depending on where you live. Click on the State or Territory where you live to find out more.
Yes, you can change or revoke your advance care directive while you are still able to make medical decisions for yourself. If you want to either make changes or revoke your directive, the best avenue is to make a new directive and destroy any old ones.
Make sure you tell everyone who had a copy of your previous directive that you have done this and give them a copy of your new directive.
No, definitely not. Euthanasia is the deliberate action of causing the death of someone who otherwise would not die. This is completely different from the withdrawal of a treatment that is regarded by the patient, the doctors, the substitute decision-maker or family as futile or overly burdensome. In this circumstance the patient is dying from the underlying illness and nature is being allowed to “take its course”.
NOTE: In all Australian states and territories euthanasia is illegal.
If you have discussed your wishes with your substitute decision maker and family, they will be able to pass on this information to medical staff as they will be the ones contacted to discuss your condition.
They will also be able to provide your advance care directive to whoever is responsible for your care.
When there is an emergency and your advance care directive is available, medical decisions will be made by reviewing your wishes and discussing your situation with your substitute decision make and family.
If your directive is not immediately available, life-prolonging measures may be started until medical staff can contact your family. If it is clear after discussions with your substitute decision maker and family that your wishes would be to stop treatment, this can then occur.
If you become unwell and cannot communicate for yourself, doctors will make treatment decisions based on your best interests. This could include treatments that you might not want. If you feel strongly about certain types of treatment that you would not want to receive, than an advance care directive is a good way to communicate those wishes.
Yes, you can legally refuse treatment or ask for some types of treatment to be withdrawn. In some states, nominated substitute decisions makers can also refuse treatment if they know or believe that to be your wish.