Advance Care Directives

What is an Advance Care Directive?

An Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters. It replaces Enduring Powers of Guardianship, Medical Powers of Attorney and Anticipatory Directions with a single Advance Care Directive Form.

An Advance Care Directive allows you to:
• write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters and/or
• appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.

A Substitute Decision-Maker is an adult you choose and appoint in your Advance Care Directive to make decisions about your future health care, end of life, living arrangements and other personal matters when you are unable to make these decisions for yourself, whether for a short time only or permanently. The Substitute Decision-Maker(s) must sign the Form and accept their role.

Why should I complete an Advance Care Directive?

At some point in your life, there may come a time when you may be unable to make your own decisions. It could be because:
• of a sudden accident or serious mental health episode
• of dementia or similar condition
• of a sudden serious stroke
• you are unconscious or in a coma.

If this happened, how would you want decisions to be made for you about your health care, living arrangements and other personal matters? More importantly, who would you want making these decisions for you? An Advance Care Directive makes it easy for others to know what your wishes are when you are unable to make these decisions yourself. It also gives you peace of mind to know that your wishes will be known and can be respected, if others need to make decisions for you.

What the Advance Care Directive is not

An Advance Care Directive is not a Will. It also cannot be used to make financial or legal decisions. The Law Society of South Australia recommends that you think about putting in place an Enduring Power of Attorney to make decisions about your future finances and legal matters.

When will my Advance Care Directive come into effect?

Your Advance Care Directive only takes effect (can only be used) when you are unable to make your own decisions. You can make your own decision if you can:
• understand information about the decision
• understand and appreciate the risks and benefits of the choices
• remember the information for a short time
• tell someone what the decision is, and why you have made the decision.

If, in the future you are unable to do these four things, it means you are unable to make the decision and someone else will need to make the decision for you.

What if I have other documents in place?

If you already have a valid Enduring Power of Guardianship, a Medical Power of Attorney or an Anticipatory Direction and they still conform with your wishes, these are still legally effective unless you complete an Advance Care Directive Form.

Who can write an Advance Care Directive?

You can write an Advance Care Directive at any stage of life – whether you are young, older, healthy or unwell. To write an Advance Care Directive: -
• it must be your choice;
• it must be in the approved form;
• you must be 18 years old or over;
• you must know what an Advance Care Directive is;
• you must know what it will be used for; and
• you must know when it will be used.

What about end of life decisions?

You are able to make binding refusals of certain health care in your Advance Care Directive. This includes refusals of life sustaining measures should you ever be in a persistent vegetative state or in the terminal phase of a terminal illness.

What if I don't have an Advance Care Directive?

Certain people may still make decisions in relation to your health care if you lose the ability to do so yourself, but may argue over who makes decisions for you if they do not know your wishes. This might not necessarily include family members. An Advance Care Directive formally records your wishes and allows you to avoid arguments amongst your family members as to who has priority to make decisions for you.

It is best to seek professional help to prepare your Advance Care Directive

Whilst you can prepare an Advance Care Directive yourself, it is advisable to seek professional advice given the importance of the document.  Your wishes and instructions in the Advance Care Directive need to be carefully considered and clearly expressed. A doctor could discuss with you your particular medical circumstances and help you understand the implications of the instructions and wishes you are considering including in your Advance Care Directive. A lawyer can assist you with the preparation of your Advance Care Directive and the precise wording to adopt to give effect to your wishes and in the signing process by acting as an authorised witness. 

Further Information

For further information please visit the Advance Care Directives website: http://www.advancecaredirectives.sa.gov.au/

Need a Lawyer?

Contact the Law Society on (08) 8229 0200.