Advance Care Directive (Australia)

An Advance Care Directive in Australia records a person's wishes about future medical treatment and care for use if they later lose capacity to decide for themselves, recognised under state Advance Care Directive and Guardianship legislation.

In Australia, advance care directives are governed by state and territory legislation, and the name, formal requirements, and legal effect vary between jurisdictions. In South Australia, the Advance Care Directives Act 2013 (SA) provides a thorough statutory ACD framework with legally binding force. In Victoria, the Medical Treatment Planning and Decisions Act 2016 (VIC) establishes the framework for Advance Care Directives and the appointment of a Medical Treatment Decision Maker. In New South Wales, advance care planning is primarily achieved through an Appointment of Enduring Guardian under the Guardianship Act 1987 (NSW) and informal advance care directives that express healthcare wishes. Queensland allows a combined financial and personal/health power of attorney under the Powers of Attorney Act 1998 (QLD). Other states and territories have equivalent legislation.

An Advance Care Directive typically performs two functions. First, it records your instructional directives — your specific wishes about healthcare, including consent to or refusal of particular treatments. Second, it appoints a substitute decision-maker (sometimes called a healthcare agent, enduring guardian, or medical treatment decision maker) who is authorised to make healthcare decisions on your behalf when you lack capacity, guided by your stated wishes and values.

Common matters addressed in an ACD include life-sustaining treatment preferences (such as cardiopulmonary resuscitation, artificial ventilation, or artificial nutrition and hydration) in terminal conditions; palliative care and pain management preferences; preferred location of care; cultural, religious, and personal values; and organ and tissue donation wishes.

For healthcare providers, a properly executed ACD provides legal authority and clarity. In most jurisdictions, treating health professionals who act in good faith in accordance with a valid ACD are protected from civil and criminal liability under the applicable legislation. An ACD can prevent unwanted interventions and spare families from having to make agonising decisions without guidance.

The legal framework governing the Advance Care Directive (Australia) in Australia draws on several key statutes and regulatory bodies. Under state succession legislation — including the Succession Act 2006 (NSW), Wills Act 1997 (Vic), and Succession Act 1981 (Qld) — the Supreme Court of each state administers probate. The Trustee Act 1925 (NSW) and equivalent state Acts govern trustee obligations. The Australian Taxation Office (ATO) administers estate taxation. Section 7 of the Succession Act 2006 (NSW) sets formal requirements for valid wills. The Privacy Act 1988 (Cth) applies to personal data held by executors and administrators. Parties executing a Advance Care Directive (Australia) in Australia should confirm the document reflects current law, including any amendments enacted since the original drafting date. The State Advance Care Directive / Guardianship Acts (e.g. Advance Care Directives Act 2013 (SA); Medical Treatment Planning and Decisions Act 2016 (Vic); Guardianship Act 1987 (NSW)) sets the foundational requirements.

An Advance Care Directive is relevant for every Australian adult, not only those who are elderly or seriously ill. Accidents, sudden illness, and medical emergencies can occur at any stage of life, and without a documented Advance Care Directive, your treating medical team and your family may not know what treatment you would want.

Older Australians facing the possibility of cognitive decline — including those in the early stages of dementia — should prioritise making an ACD while they have legal capacity, because once capacity is lost it is too late to make one. Aged care facilities and hospitals in Australia actively encourage residents and patients to complete advance care planning documents as part of their admission and ongoing care processes.

People with a serious or life-limiting illness — including cancer, heart failure, chronic obstructive pulmonary disease, or other conditions with a foreseeable terminal trajectory — benefit enormously from an ACD that guides their care through potentially complex end-of-life decisions. An ACD can reduce unwanted hospitalisations and interventions and improve the alignment of care with the person's expressed wishes.

Adults of any age who have strong views about particular treatments — such as a refusal of blood transfusions on religious grounds, or a strong preference to avoid artificial ventilation — should document those views in an ACD so that they are known to healthcare providers in any emergency setting.

People with a disability, chronic illness, or a condition that may at some future point affect their capacity should complete an ACD as part of their overall health and legal planning. The Advance Care Directives Act 2013 (SA) is notable for its explicit inclusion of non-terminal conditions and its recognition of capacity as a spectrum rather than an all-or-nothing concept.

You should review and update your ACD whenever your health status, values, or wishes change significantly, and at least every five years as a matter of routine practice. Changes in your relationships — particularly the breakdown of a marriage or partnership where the former partner was nominated as healthcare agent — require urgent updating of the document.

A well-drafted Australian Advance Care Directive should contain the following key elements.

Principal identification establishes who is making the document. It should include your full legal name, date of birth, address, and state or territory of residence. A clear declaration that you have decision-making capacity at the time of execution is important, particularly if the document is ever scrutinised.

The appointment of a substitute decision-maker (healthcare agent) is a central element. The document should clearly identify the person you are appointing, their relationship to you, and their contact details. If the appointed agent is unavailable, alternate agents or a hierarchy of decision-makers should be identified.

Instructional directives record your specific wishes about healthcare. These should be as clear and specific as possible. Vague statements ('I don't want to be kept alive by machines') may not give sufficient guidance in a clinical setting. Good instructional directives specify particular treatments in particular clinical circumstances — for example, 'If I am in a permanent vegetative state with no reasonable prospect of recovery of awareness, I do not consent to artificial ventilation, cardiopulmonary resuscitation, or artificial nutrition and hydration.'

A values and goals statement records the personal, cultural, and spiritual values that should guide your care. This is particularly important in situations not specifically covered by your instructional directives, because it gives your healthcare agent and clinicians a framework for making decisions that reflect who you are and what matters to you.

Palliative care and pain management preferences should state clearly that you wish to receive adequate pain relief and comfort care even if that may, as a secondary effect, hasten death — this is a well-established principle under Australian medical ethics and law.

Organ and tissue donation preferences should be recorded, though registration on the Australian Organ Donor Register is the primary mechanism for formalising donation decisions.

Execution formalities — signature, date, and witness attestation — must comply with the requirements of the relevant state or territory legislation. An improperly witnessed ACD may not have legal effect. Copies should be provided to your healthcare agent, GP, specialist, hospital, and any residential aged care facility where you reside.

Additional compliance elements for a Advance Care Directive (Australia) used in Australia include: Under state succession legislation — including the Succession Act 2006 (NSW), Wills Act 1997 (Vic), and Succession Act 1981 (Qld) — the Supreme Court of each state administers probate. The Trustee Act 1925 (NSW) and equivalent state Acts govern trustee obligations. The Australian Taxation Office (ATO) administers estate taxation. Section 7 of the Succession Act 2006 (NSW) sets formal requirements for valid wills. The Privacy Act 1988 (Cth) applies to personal data held by executors and administrators. Forms-legal.com provides this template as a starting point for Australia-compliant documentation.