ADVANCE HEALTH DIRECTIVES




An advance health directive is a legal document that enables you to give binding directions about your future health care, medical procedures and life-sustaining treatment.
Your health providers will follow the directions you provide in the advance health directive document, but may consult your health/personal attorney for matters not covered by you in the document.

The person making the advance health directive document.
If you did not appoint an attorney for health matters in your enduring power of attorney document, you can appoint an attorney for health matters in the advance health directive document.
Your health providers must follow the directions you provide in the advance health directive document but may consult your health/personal attorney for matters not covered by you in the document.
Your attorney cannot make decisions that are inconsistent with your directions in the advance health directive document, so long as those directions are clear and can be followed by your health care providers.
The advance health directive document appears to be lengthy but you can elect to cross out items that do not concern you and elect to tick one box only to provide your directions about life-sustaining measures.
Alternatively, you can provide detailed information about a number of your health conditions and concerns, your views, wishes and preferences.
You must first complete the advance health directive document in consultation with your general practitioner or other medical practitioner.
Once you have completed the advance health directive document with your doctor, you must then sign the completed document in front of an eligible witness (that is, a justice of the peace, commissioner for declarations, lawyer or notary public).
Your advance health directive can only be used when you do not have capacity to make your own healthcare and medical decisions.
If you are temporarily incapacitated (for example, during an illness), the advance health directive can only be used during the time you are unable to make you own decisions.
Health matters relate to decisions about your health care, such as:-
- most medical treatments (except “special health matters”)
- procedures and services to treat physical and/or mental conditions.
If you are nearing the end of your life, health care includes treatments aimed at keeping you alive or delaying your death (that is, life-sustaining treatments)
If you have an attorney for person/health matters, they cannot make decisions for special health matters.
Special health matters include procedures such as removal of tissue for tissue donation to another person, sterilisation, termination of a pregnancy, participation in special medical research, experimental health care and some mental illness procedures.
Capacity is a legal concept that has different meanings and requirements, depending on the decision or situation in question. There is a specific legal test of capacity for a principal to make an advance health directive.
Capacity to make an advance health directive means that the principal:
- is capable of making the advance health directive freely and voluntarily and
- understands the nature and effect of the advance health directive.
To be eligible to be your attorney, they must:-
- be 18 years or older
- have capacity to make the decisions they are appointed for
- not be your paid carer or have been your paid carer in the last three years (a person is not a ‘paid carer’ if they just receive a Centrelink carer’s pension for looking after you)
- not be your health provider
- not be a service provider for a residential service where you live
(The term ‘attorney’ does not mean ‘lawyer’)
You should consider appointing a person as your attorney for personal / health matters who:
- you trust to make decision you would agree with about your personal care and health care and welfare
- you have discussed your views, wishes and preferences with
- will put your needs, rights and interests ahead of their won and others in all decisions
- will understand their legal obligations and duties as an attorney for personal (including health) matters
- will be available to make healthcare decisions and decisions about your care and welfare on your behalf
- will be confident in discussing your health care with your health care providers.
If you are nearing the end of your life, life sustaining treatment are those treatments aimed at keeping you alive or delaying your death, such as:-
- cardiopulmonary resuscitation (CPR)
- assisted ventilation (a machine to assist you breathing)
- artificial nutrition (via a feeding tube)
Yes, you can consent to, or refuse blood transfusions in your advance health directive.
You can also specify the circumstances or types of transfusions you consent to or refuse.
Your statutory health attorney is the first person who is readily available and culturally appropriate in a list provided in the Powers of Attorney Act 1998.
The listed order is:-
- a spouse
- a person who has the care of the person
- a person who is a close friend or relation of the adult
- the Public Guardian
By appointing a personal/health attorney in an enduring power of attorney or a health attorney in an advance health directive, you can choose the person to make health care decisions on your behalf, in the event that your medical practitioners need directions.