Person Responsible

A Person Responsible for an adult (18 years and over) will  be one of the following in order of priority:

• a guardian if the order or instrument appointing the guardian provides authority for the guardian to make medical and dental treatment decisions. This includes an enduring guardian;
• the person's spouse with whom they have a close and continuing relationship;
• a carer;
• a close family member of the person, who has a close personal relationship with the person through frequent personal contact and who has a personal interest in the person's welfare.

Definition of carer, close family member and close friend

Carer is a person who provides services and support for the person, or arranges services and support (or did before the person entered residential care). Apart from receiving a carer payment (or similar), to be a carer, the person must perform the role unpaid.

Close family member means any of the following people who are in a close and continuing relationship with the person through frequent personal contact and a personal interest in the person's welfare, and is not paid for providing services (apart from receiving a carers payment):

• a spouse;
• a parent;
• a person who has one or both parents in common with the person;
• a child;
• a child of, or a parent of, the spouse of the person;
• a grandparent;
• an aunt or uncle;
• an adult of Aboriginal or Torres Strait descent who is related to the person  according to Aboriginal kinship rules or Torres Strait Islander kinship rules (as the case requires);
• any other carer or close friend who provides on-going personal support to the person, whether or not the other person is biologically related to the person.

Close friend means another person who has a close personal relationship with the person and a personal interest in the person's welfare.

A Person Responsible must make medical and dental treatment decisions that promote the personal and social wellbeing of the person.

When making a treatment decision for a person, the Person Responsible must:

• determine the wishes, directions, preferences and values of the person (including those expressed in an Advance Care Directive) so far as possible; and
• know and understand:
  • what the proposed treatment is and the consequences if it is not carried out
  • any alternative treatment;
  • the nature and degree of any significant risks with the proposed treatment and any alternate treatment; and
  • be satisfied that the treatment is to be carried out only to promote and maintain the person's health and wellbeing.

A medical practitioner has a responsibility to give the Person Responsible information about the proposed treatment and seek their consent to treat before treating a person. Consent should be provided in writing. If this is not practicable, consent can be given orally or later confirmed in writing.

No.

There are some instances where a Person Responsible's consent is not required. These include:

• where there is a medical or dental emergency and the treatment is considered urgent.  This is covered by sections 40 and 41 of the Guardianship and Administration Act 1995. Treatment considered urgent includes:
  • to save a person's life;
  • to prevent serious damage to the person's health;
  • to prevent the person suffering significant pain or distress (not including special treatment).
• when the treatment is minor. For example:
  • a visual examination of the patient's mouth, eyes, ears or throat;
  • providing first aid;
  • the administration of a non-prescription drug  (such as pain killers or an antihistamine) within recommended dosages.

Yes.

A Person Responsible cannot sent to special treatment. Only the Tasmanian Civil and Administrative Tribunal (TASCAT) can consent to special treatment. Special treatment is:

• treatment likely lead to infertility;
• termination of pregnancy;
• removal of tissue for transplant;
• psychosurgery; or
• any treatment involving an aversion stimulus.

If treatment is proposed for a person who is incapable of providing their own consent and they have no Person Responsible, there are some circumstances where consent is not required.

If the proposed treatment is not special treatment, the person is not known to have objected to the proposed treatment, and the medical practitioner or dentist has taken reasonable steps to see if the person has an Advanced Care Directive and is also satisfied that the proposed treatment is the form of treatment that will most successfully promote the person's health and well-being, then treatment can be carried out without consent.

If there is a Person Responsible but they cannot or do not want to make the treatment decision, or there is a conflict between multiple Person's Responsible, an application can be made to TASCAT.