What is an Advance Health Directive?
An Advance Health Directive is a legal document that enables you to make decisions now about the treatment you would want – or not want – to receive if you ever became sick or injured and were incapable of communicating your wishes. In such circumstances, your AHD would effectively become your voice.
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 you would want – or not want –receive if you ever became sick or injured and were incapable of communicating your wishes.
It will also help to reassure you and your loved ones that they have a clear idea of what is desired by you in the event of illness or injury.
How do I make an Advance Health Directive?
The Guide to Making an Advance Health Directive in WA (PDF 500KB) provides detailed instructions on how to complete an Advance Health Directive including how to make sure it is signed and witnessed. You can access the Advance Health Directive online or order a hard copy from the Department of Health Advance Care Planning Information Line on phone 9222 2300 or email: ACP@health.wa.gov.au.
What if I do not make an Advance Health Directive?
If you do not make an Advance Health Directive, a health professional must go to the first person listed on the hierarchy, who is 18 years or older, has full legal capacity, and is available and willing to make the treatment decision.
If the first person is not available and willing to make the decision, the health professional can go to the next person in the hierarchy, and so on.
When will my Advance Health Directive be used?
Your Advance Health Directive will only be used at times when you are unable to make and/or communicate decisions about your treatment and health care and if it applies to the treatment that you require.
How long is my Advance Health Directive valid?
Decisions you make in your Advance Health Directive are valid:
- until you die or
- until you revoke (cancel) your Advance Health Directive or
- while the treatment options listed in your Advance Health Directive remain relevant. Your Advance Health Directive will not apply to new treatment options that may become available after you complete the Advance Health Directive.
If I used an old version of the form for my Advance Health Directive is it still valid?
Yes. If you made an Advance Health Directive using an old version of the form prior to 4 February 2023 and you followed all legal requirements to complete the form, it will continue to be valid.
If you are making a new Advance Health Directive, you should use the current Advance Health Directive form.
If you use the old form past 4 February 2023 it may not be considered a valid Advance Health Directive,in accordance with the Guardianship and Administration Act 1990.
Do I need to speak to a medical professional when completing an AHD?
You do not have to speak to a medical professional when completing an AHD but it is strongly recommended.
The more complex and specific your wishes in your AHD are, the more value there is in seeking professional help in preparing your AHD. Discussing with a medical professional lets you check your understanding of the consequences of the decisions you have recorded or intend to record.
In particular, if you are thinking about refusing all life-sustaining treatment in your AHD, it is recommended you speak with your GP/specialist so you understand the implications of that decision, particularly if you don’t currently have a diagnosis of a life-limiting illness.
Will my health professional always need to follow my decisions in my Advance Health Directive?
Yes. In most situations, if you become unable to make or communicate decisions about your treatment and care, health professionals must follow the decisions in your Advance Health Directive, except in some limited exceptions. A limited exception may occur if:
-
- circumstances relevant to your treatment decision have changed since you made the treatment decision, and
- you could not have reasonably anticipated those changes when you made your Advance Health Directive, and
- it is likely that a reasonable person with knowledge of the change of circumstances would change their mind about the treatment decision.
How often and when should I review my Advance Health Directive?
It is recommended you review your Advance Health Directive every 2 to 5 years, or if your circumstances change. For example, if you are diagnosed with a new ongoing and/or life-limiting illness you may need to review your Advance Health Directive earlier than 2 to 5 years. You will need to revoke any previous Advance Health Directives to make a new one.
To revoke an AHD, you must have full legal capacity. The law provides safeguards to ensure that AHDs cannot be made, amended or revoked if a person does not have capacity. Legislation does not spell out the process of revoking an AHD, the process is governed by common law. Written revocation of the AHD is not a legal requirement. There is a statement within the AHD template that allows you to indicate you are revoking any previous versions.
The Department recommends that you give written notification of the revocation to all relevant persons and organisations, including GPs, healthcare providers and family members and those who currently hold a copy of the AHD being revoked. All those who hold a copy should return it to you to be destroyed.
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 your decisions about treatment(s) you do or do not want to receive if you 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 your wishes.
What if nobody can access my Advance Health Directive in an emergency situation?
Treatment is regarded as urgent or an emergency if it is needed to save a person's life or prevent the person from suffering significant pain or distress.
Where a person requires urgent treatment and it is not practicable for the health professional to determine whether an Advance Health Directive has been made or to obtain a treatment decision from anybody in the hierarchy of treatment decision-makers (PDF 1.5MB), the health professional may provide the necessary treatment.
In cases where a person is in need of urgent treatment that the health professional believes is the result of attempted suicide, the health professional may administer the necessary treatment even:
- if the person has made an Advance Health Directive in which consent for the required treatment is withheld
- the person's guardian, enduring guardian or person with authority to make a decision withholds consent.