What is an advance care directive in Australia?
An advance care directive (ACD) is a document recording your medical treatment preferences if you lose capacity to make decisions, and appointing a substitute decision-maker to act on your behalf. Each state and territory has its own legislation and form — Advance Care Directives Act 2013 (SA), the Medical Treatment Planning and Decisions Act 2016 (VIC), and equivalents. ACDs are distinct from enduring powers of attorney, which cover financial matters.
State variations
Legal form varies significantly. VIC: statutory binding instructional directive or values directive under the Medical Treatment Planning and Decisions Act 2016 (VIC). NSW: common law advance care directive, or appointment of enduring guardian under Guardianship Act 1987 (NSW) for substitute decisions. SA: Advance Care Directives Act 2013 (SA) unifies directives and substitute decision-making. QLD: advance health directive under the Powers of Attorney Act 1998 (QLD). WA: Guardianship and Administration Act 1990 (WA).
What an ACD covers
Treatment refusals (e.g., refusing mechanical ventilation in specific circumstances); values and preferences to guide decision-makers; preferred place of care; pain management preferences; appointment of substitute decision-maker. Most ACDs can include religious and cultural considerations and donation wishes (though organ donation is separately registered).
Binding vs advisory
A statutory binding instructional directive in VIC, SA, and some other states must be followed by health practitioners. Advisory directives and values-based ACDs guide substitute decision-makers. Health practitioners are generally immune from liability for following a valid ACD.
How I help estate planning lawyers
I draft ACDs in state-compliant form, including values statements, treatment refusals, and substitute decision-maker appointments. For estate planners offering comprehensive estate plans alongside wills and EPOAs, this is a standard part of the package.
Common issues
- Statutory forms differ by state — use the right form for the jurisdiction
- ACDs should be updated after significant health events or changes in values
- Copies should be held by GP, hospital record, and substitute decision-maker
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