Advance care directive: what it is and why you should have one

What is an advance care directive?

You can think of an advance care directive as your own guide for your health care and medical preferences. It’s a legal estate planning document that lets you outline your values, needs and preferences for future medical treatment and end-of-life care. If you suddenly suffer from a life-threatening injury or are diagnosed with a terminal illness, an advance care directive can help communicate your wishes.

Why is it important to have an advance care directive?

Despite our best-laid plans, we never know what’s around the corner. That said, many of us probably have a strong idea about what we’d like to happen if we become significantly injured or ill.

In the event that you can’t tell your family what you want, an advance care directive is your way of letting them know. It can act as a map to guide them through difficult decisions, particularly when they might hold conflicting opinions about what should happen.

What happens if I don’t have an advance care directive?

If you’re in the position where you can’t make medical decisions on your own behalf and you don’t have an advance care directive, your doctors and carers will generally ask your close family members to make the relevant treatment decisions.

While this can be a suitable option due to the circumstances, your family might have conflicting views that don’t align with your values or preferred outcomes.

How does an advanced care directive work?

As it is considered a legal document, you can make an advance care directive if you are over the age of 18. An advance care directive comes into effect if you no longer have the capacity to make day-to-day decisions for things like:

• legal concerns

• health care and medical treatment

• finances

• personal matters

It’s best practice to discuss your situation and advance care directive with your doctor so you’re both aware of what could happen and what should inform your plan.

Regardless of what you choose, it’s important to remember:

• you won’t lose the ability to control your own decisions by having a directive

• you can change your directive at any time (but make sure everyone who’s received your original directive gets the new one)

• your family members and health professionals need to follow your valid directive if you’re unable to communicate your end-of-life wishes

While it’s not necessary to engage a lawyer for your directive to be valid, it is recommended that you get legal advice to understand the requirements of an advance care directive in your state or territory and discuss how a directive can form part of your overall estate plan.

What does an advance care directive include?

Your advance directive is relatively simple in what information it should have. It can include:

• details of your personal values or religious beliefs

• your preferred health outcomes

• types of medical treatment and care you’d like or wouldn’t like if you have a life-threatening medical condition

When it comes to deciding what you should write in your advance care directive, your preferences might detail whether you’d want to:

• be kept alive on a ventilator or revived

• die at home in your own bed, in a hospital or aged care facility

• donate organs and tissues (you’ll still need to register with the Australian Organ Register)

• have invasive or costly treatments with uncertain outcomes

There are forms available for each state and territory to help you start this process. While it doesn’t need to be officially registered, it is recommended that you upload the directive to your My Health Record for safekeeping and easy access for your doctors.

What’s the difference between an advance health directive and an enduring guardianship?

Although they can complement each other, it’s important to know that an advance care directive is different to an enduring guardianship. Both are important in the event you’re unable to make your own medical decisions. Whilst an advance care directive sets out your wishes and preferences for medical treatment, an enduring guardianship legally appoints someone to make these medical decisions on your behalf.

Each state and territory has their own process to follow. In South Australian and the Northern Territory, you can appoint someone close to you as your substitute decision-maker in your advance care directive. In New South Wales and Tasmania, you need to complete a separate form to nominate an enduring guardian. Similarly, the ACT and Queensland have a separate form to appoint an enduring power of attorney, while Western Australia refers to the separate form as an enduring power of guardianship.

Whoever you choose will help you when you’re no longer able to make decisions for yourself. Your advance care directive can be used as a guide to help them to act on your behalf.

Do I need to have an advance care directive signed in Australia?

For the directive to be recognised as a legally binding document, every state and territory has their own terms and requirements for who needs to sign it, as well as varying names for the document.

We’ve compiled a few important points for each state and territory below:

An advance care directive in New South Wales:

• doesn’t need to be witnessed or signed to be legally enforceable

An advance care directive in Victoria needs to be:

• signed by two independent adults (including one who is a general practitioner)

An advance health directive in Queensland needs:

• a doctor to complete Section 5 of the document

• a witness to complete Section 9 of the document

• the witness to be at least 21 years old (who is a justice of the peace, lawyer, notary public, or commissioner for declarations)

• the witness to be completely independent from you (who isn’t a relative, personal attorney, beneficiary in your Will, or currently working as your paid carer or health professional)

An advance personal plan in Northern Territory needs to be:

• signed by an authorised witness (who is a justice of the peace, commissioner for oaths, police officer, legal practitioner, health professional, accountant, social worker, principal, or chief executive officer of local government authorities)

An advance care plan in the ACT needs to be:

• signed by two witnesses in attendance with each other and yourself

An advance care directive in South Australia needs to be:

• signed by one authorised independent witness

An advance health directive in Western Australia needs to:

• be signed by an authorised witness (who is a justice of the peace, lawyer, or health professional)

• include a statement that verifies you’ve received legal or medical advice before writing the document

An advance care directive in Tasmania needs to be:

• signed by a witness over 18 years old (who is unrelated to you and not a beneficiary in your Will)

Transforming end-of-life care

We’re here to help you navigate the uncertainty that comes with death and dying. From easily writing your Will with our online platform to planning your own funeral with our empathetic arrangers, our team provides end-of-life services that support you in moving forward on your terms.