What is an Advance Health Directive?
An Advance Health Directive (AHD) is a legal document that enables a person to make decisions now about the treatment they would want - or not want - to receive if they ever became sick or injured and were incapable of communicating their wishes. In such circumstances, their AHD would effectively become their voice.
The term 'treatment' includes medical, surgical and dental treatments, including palliative care and life-sustaining measures.
An AHD would come into effect only if it applied to the treatment a person required and only if the person was unable to make reasoned judgements about a treatment decision at the time that the treatment was required.
Why is it helpful to make an Advance Health Directive?
Completing an Advance Health Directive is helpful as it will allow health professionals to know what treatment a person would want - or not want - to receive if they ever became sick or injured and were incapable of communicating their wishes.
It will also help to reassure the person and their loved ones that they have a clear idea of what is desired by the person in the event of illness or injury.
What if a person has not made an Advance Health Directive?
An AHD is voluntary, a person does not have to make one. There is a hierarchy of treatment decision makers (PDF 1.6MB) that health professionals are required to follow, which is designed to give the authority to those who are most likely to know the person’s values, beliefs and preferences. At the top of the hierarchy is the Advance Health Directive.
If a person identified as being a decision maker (also known as the person responsible) is not contactable or readily available or declines to make a decision, health professionals need to contact the next person responsible in the hierarchy of decision makers.
When will an Advance Health Directive be used?
An Advance Health Directive will only be used at times when an individual is unable to make and/or communicate decisions about their treatment and health care and if it applies to the treatment that they require. In these circumstances, the AHD acts as the person’s voice as it was made before they lost capacity and it expresses their values, beliefs and preferences.
How long is an Advance Health Directive valid?
Decisions an individual makes in an Advance Health Directive are valid:
- until they die or
- until they revoke (cancel) their Advance Health Directive or
- while the treatment options listed in their Advance Health Directive remain relevant. An existing Advance Health Directive will not apply to new treatment options that may become available after an individual completes the Advance Health Directive.
If a person used an old version of the form for their Advance Health Directive is it still valid?
Yes. If the person made an Advance Health Directive using an old version of the form prior to 4 February 2023 and they followed all legal requirements to complete the form, it will continue to be valid.
If they are making a new Advance Health Directive, they should use the current Advance Health Directive form prescribed under the Guardianship and Administration Act 1990.
If they use the old form past 4 February 2023 it may not be considered a valid Advance Health Directive in accordance with the legal requirements of the Guardianship and Administration Act 1990.
How often and when should a person review their Advance Health Directive?
It is recommended that individuals review their Advance Health Directive every 2 to 5 years, or if their circumstances change. For example, if they are diagnosed with a new ongoing and/or life limiting illness they may need to review their Advance Health Directive earlier than 2 to 5 years.
Rather than amending an Advance Health Directive, individuals should complete a new Advance Health Directive (PDF 548KB), making sure that it complies with the witness requirements.
The person will need to revoke any previous Advance Health Directives.
What is the difference between a Common Law Directive and an Advance Health Directive?
Common Law Directives are written or verbal communications which convey a person’s wishes regarding future health and personal care to be provided or withheld in specific future circumstances. There are no formal requirements in relation to Common Law Directives. There can be significant difficulties in establishing that a particular Common Law Directive is valid at law and can be followed. For this reason they are not recommended for making treatment decisions.
An Advance Health Directive is a legal record of an individual’s decisions about treatment(s) they do or do not want to receive if they become unwell or injured in future. It can only be made by a person older than 18 years who is able to make and communicate their own decisions. The Advance Health Directive is a statutory document as it is recognised under legislation. Statutory documents are the strongest and most formal way to record an individual’s wishes.
Do people need to speak to a medical professional when completing an AHD?
It is not essential to speak to a medical professional when completing an AHD but it is strongly recommended.
Although the idea that a person should be able to prepare an AHD without medical and/or legal advice is ideal, the more complex and specific a person wishes to make their AHD, the greater value there is in seeking professional assistance in preparing the AHD. Discussing this with a medical professional provides people with an opportunity to clarify and check their understanding of the implications of the decisions they have recorded or intend to record.
In particular, if a person is considering refusing all life-sustaining treatment in AHD, it is recommended they speak with their GP/ specialist so they understand the implications of the decision, particularly if they don’t currently have a diagnosis of a life-limiting illness.