What you need to know about Advance Care Directive

You asked and we listened! WYZA reader Jan asked us to write a piece on ACD. What else would you like to read about? Email us at admin@wyza.com.au

I would be very interested to see WYZA follow up on this topic with an article/information about what an advance health care directive is, and how important it is to have one, particularly as we enter our retirement years. Also worth mentioning, is how important it is to discuss this issue with family members who often can't "let go" of elderly/dying hospitalised relatives and put them through unnecessary treatments and associated pain, when death is inevitable.” - Jan

Here’s how to set guidelines about your future medical treatment in advance in case an illness or injury leaves you unable to make decisions in the future. It is difficult to think about but doing so can help relieve some stress on you and your family at a difficult time.

While we are in relatively good health, it is difficult to imagine that one day we may become incapable of making or communicating decisions about our medical care. None of us ever plan to be in such a situation, but the reality is that it can happen in the blink of an eye. A sudden illness or an unfortunate accident may temporarily or permanently leave us without the faculties to decide on our treatment options.

In many cases this can put an overwhelming stress on family who are left to try and discern your wishes and balance decisions regarding such critical issues as prolonging life and relieving suffering. Fortunately, there is a way to pre-empt this situation, maintain control of how you want your treatment managed and relieve your family of such heart wrenching decisions.

An Advance Care Directive (sometimes known has an Advance Health Directive) allows you to formally express your wishes about your care in certain crisis situations well in advance of anything happening.

What is an Advance Care Directive?

Everybody has the legal right to accept or refuse health care treatments. When you are well enough to speak for yourself, you can make your own judgements about this based on the medical advice and options you are given. But what if you were unconscious or unable to express your wishes? Would you want someone else making decisions for you?

By recording your wishes through an Advanced Care Directive (ACD) you can direct or influence such decisions in advance. It is a document that states your wishes about your health care for various medical conditions, which can then be used as a guiding reference in the future if you become unable to make your own decisions.


Watch Janice's story as a decision maker for her friend Karen

Specifically, it can let you spell out:

  • limitations on treatment you wish to have, including in relation to terminal conditions
  • treatment preferences in relation to your religious beliefs or personal values
  • situations in which you would not want life support treatments employed, such as artificial respiration
  • a person to whom you want to delegate responsibility for dealing with medical practitioners
  • other non-medical issues relating to your care.

It is natural for close relatives to be reluctant to let go of someone who is in a terminal or critical condition, so an ACD will help take this burden of decision away from them and let you have your say about last-ditch treatments that may simply be prolonging suffering.

There are limits to what it can legally do

While an ACD does let you retain responsibility for your care, it is not an open ended document with unlimited power. It allows you to give specifics on your treatment wishes in certain medical situations, but it does not allow you to make any illegal requests and it cannot in any way allow you to request or give instruction on euthanasia.

They are also limited from allowing you to make requests on issues of basic care, such as hygiene and food.

In a medical sense, it does not replace a clinical treatment plan, but rather provides a reference to inform the treatment plan developed by your medical professionals.

Act on your ACD while you are in good health

It simply makes good sense to deal with such an issue while you have your faculties about you, so that you can relieve your loved ones of making decisions that they may not be confident or comfortable about making.

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For more information about ACD head to government websites or ask your health professional

When putting your ACD together, it’s wise to consult with family members so that they are aware of the thinking behind your preferences, as well as giving them the opportunity to talk through their concerns about your decisions.

It’s also a good idea to involve your general practitioner in your deliberations, so that they can answer questions and clarify any concerns you have from a medical perspective.

Variations between different states

Each state also has its own particular rules, regulations and documentation in relation to ACD’s, so check with your own state health authorities, your doctor or your legal adviser if you have questions on specifics for your state.

No matter what age you are now or what health condition you are in, planning ahead with an ACD today can relieve a lot of heartache and difficulty for your family in the future.

What are your thoughts on the Advanced Care Directives? Have you witnessed the benefits of an ACD in real situations? Join the discussion below.