Decisions about my health

It’s therefore a good idea to discuss your wishes about future health care with your family and friends (and enduring guardian if you have appointed one). Otherwise, if the time comes that they need to make decisions for you, it may be hard for them to know what you would have wanted. This is called advance care planning.

You can also write your wishes down in an advance care directive.

An advance care directive (also called an advance care plan or a living will) is a written record of your wishes or instructions for doctors and health care workers about the treatment you want or don’t want in particular circumstances in the future.

An advance care directive is only used in situations when you are unable to communicate or have lost the ability to make medical treatment decisions for yourself.

It is a good idea to talk to your doctor when you make an advance care directive as your doctor can help you understand more about health conditions you may have and treatment decisions that may need to be made.

Unlike enduring powers of attorney and enduring guardianship appointments, there is no special form that you must use. However, NSW Health has an information pack which includes a form and an information booklet on the best way to document an advance care directive.NSW Health recommends that an advance care directive follow these principles:

1. It needs to be specific. It can include your preferences for treatmentfor a health condition you have now or one you may develop inthe future.
2. It needs to be kept current. Your wishes may change in the future,so it is important to review your advance care directive regularly orif there is a big change in your health. It is a good idea to note on itwhen you last reviewed it and whether or not you made any changes. 
3. You must be mentally competent. You can only make an advancecare directive while you still have the mental capacity to understandthe choices you are making.

It is also good to have it witnessed. You can choose who you ask to witness it.

You can make an advance care directive as part of appointing an enduring guardian. You can attach your advance care directive to your Appointment of Enduring Guardian form and refer to the attachment in the form itself.

Yes, although there is no special legislation in NSW that deals with advance care directives. NSW Health guidelines to doctors make it clear that if an advance care directive meets the principles set out above, doctors are legally bound to follow it.

For example, you may say in your advance care directive that if you are unable to communicate with or recognise your family and there is no realistic possibility that you will ever improve or recover, you do not want CPR (cardio pulmonary resuscitation) if your heart stops, but you only want to be kept comfortable and free from pain.

Under voluntary assisted dying laws in NSW, in certain circumstances, you can authorise and direct that a medical procedure be carried out to end your life. You must be mentally capable and suffering from a terminal illness at the time. This is highly regulated, and you should discuss this with your doctor.

No, it is up to you. Everyone is different and you may prefer to leave such decisions to your partner, a person caring for you, or a relative or close friend who knows you well and you trust to make decisions for you.

Even just talking over what you would want will at least help them to know what you would have wanted if they ever have to make such decisions for you. This is called advance care planning

No, there is no special form that you must use. You can write your advance care directive as an open letter or you can attach it to, or incorporate it into, your Appointment of Enduring Guardian form. There is also a useful form on the NSW Health website and on the Advance Care Planning Australia website.

What is important is that however you write it, your advance care directive should meet the three points set out above.

It is a good idea to give a copy of your advance care directive to your ‘person responsible’, that is, the person most likely to be asked to give consent to medical treatment on your behalf. This will ensure the person knows your wishes and can act on them.

It is also a good idea to give a copy to your regular doctor (GP) so that they know your wishes as well. If you have already been treated at a particular hospital you could also ask your doctor to send your advance care directive to the hospital with a request that it be placed in your medical record.