How to make an Advance Care Directive in NSW
In NSW, an Advance Care Directive (ACD) is a common-law document recording your wishes about future medical treatment if you lose capacity. Unlike some states, NSW has no single statute prescribing a form — a valid ACD relies on common-law principles and the Guardianship Act 1987 (NSW) framework. A well-drafted ACD covers refusal of specific treatments, values, and preferences, and is often paired with an Appointment of Enduring Guardian.
The framework
ACDs in NSW rely on the common law (Hunter and New England Area Health Service v A [2009] NSWSC 761), the Guardianship Act 1987 (NSW) (which underpins enduring guardianship), and NSW Health policy directives on Advance Care Planning. NSW does not have prescribed statutory ACD form equivalent to SA, VIC, or QLD legislation.
The process
Confirm you have decision-making capacity
You must have capacity to understand the nature and effect of refusing or consenting to future medical treatment. If capacity is uncertain, obtain a capacity assessment before signing.
Clarify your values and goals of care
Think about what matters most — quality of life, religious beliefs, fears about treatment, desired location of death, and acceptable trade-offs between longevity and comfort.
Discuss with your doctor
Discuss your wishes with your GP or treating specialist to understand likely medical scenarios and the practical meaning of specific treatment decisions (e.g. CPR, intubation, artificial nutrition).
Choose a directive, values statement, or both
Decide whether to record specific directions (e.g. refusing CPR), broader values (e.g. comfort over longevity), or both. Specific directions are binding at common law; values guide decision-makers.
Use NSW Health's ACD form or a lawyer-drafted document
Use NSW Health's Advance Care Directive form (most widely recognised by hospitals) or a lawyer-drafted document that sets out directions, values, and the context of decision-making.
Appoint an Enduring Guardian in parallel
An ACD is strongest when paired with an Appointment of Enduring Guardian under the Guardianship Act 1987 (NSW) so a trusted person can apply your values to unforeseen situations.
Sign and witness
Sign the document. While no statutory witnessing requirement applies, have an independent witness (ideally a JP, legal practitioner, or doctor) confirm the principal appeared to have capacity and signed voluntarily.
Distribute copies
Give copies to your GP, local hospital, enduring guardian, family, and aged-care provider. Consider uploading to My Health Record so treating clinicians can access it in an emergency.
Review and update periodically
Review after a major diagnosis, significant treatment, change in family circumstances, or every 2-3 years. Replace the earlier document with a clearly dated new version and notify all holders.
Revoke in writing if circumstances change
While you have capacity you can revoke or amend the ACD. Revocation should be in writing, signed, and communicated to everyone who holds a copy.
Forms and templates
- NSW Health Advance Care Directive form
- Appointment of Enduring Guardian (NSW)
Common mistakes
- Drafting vague directions that do not refuse or consent to specific treatments
- Failing to appoint an Enduring Guardian to apply the ACD in unforeseen situations
- Not giving the ACD to the treating hospital or GP so it is unavailable in an emergency
- Confusing NSW with states that have statutory ACD forms (SA, VIC, QLD)
- Leaving the ACD unreviewed after a major diagnosis or change in circumstances
Get this process right with Quillio
Quillio drafts NSW Advance Care Directives paired with an Appointment of Enduring Guardian, tailored to your values and likely medical scenarios. See /practice-areas/wills-estates-lawyers or start a free trial at /free-trial.
General information only — not legal advice. An ACD that is vague or poorly witnessed may not be followed in an emergency. Obtain legal and medical advice for complex circumstances, progressive conditions, or religious / values-based refusals.
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