Planning ahead - decision making
Enduring guardianship, powers of attorney and advanced care directives
Many people expect that their family and friends will step in and support them in future if their circumstances change and they need increased support and/or assistance with decision-making. In most situations this kind of informal support is enough to manage day-to-day affairs. However, significant decisions may require a source of formal authority for someone to make a decision on your behalf if you’ve lost capacity to do so yourself.
Depending on your circumstances, the following may assist you to plan ahead and ensure you are in control of certain decisions about your life and who will assist you with decision-making should the need arise.
please see the enduring guardianship page for more information.
Enduring power of attorney
please see the enduring power of attorney page for more information.
Advance Care Planning
Advance care planning is a way of making sure you have a say in how your care is managed towards end of life. This involves discussions between you, your family and with your healthcare professionals about your goals and the desired direction you wish to achieve in your end of life care. It is particularly important in case you later lose the capacity to participate in discussions when difficult decisions need to be made.
What is an Advance Care Directive?
An Advance Care Directive (ACD) is a formal document used to help record your values and wishes and assist others to make decisions about your care on your behalf if you become unable.
An ACD can be used to give instructions about specific treatments you accept or refuse in the event you lose capacity to make healthcare decisions. An ACD can amount to a decision/s about your medical care in advance, so care needs to be taken to explain the treatments to which you consent or refuse and under what specific circumstances.
Are ACDs legally binding in Tasmania?
There is currently no statutory framework (legislation) for Advance Care Directives in Tasmania. However, ACDs are governed by common law (decisions made by judges in the courts) and can be legally binding.
For an Advance Care Directive to be valid and relied upon by a medial practitioner there are several relevant factors:
- The person must have had decision-making capacity at the time the ACD was made
- It must have been made free from undue influence
- The consent to or refusal of treatment must be specific enough to the situation at hand and to the proposed treatment
- There have been no significant changes to the facts and circumstances on which the ACD was based.
Note that The Guardianship and Administration Amendment (Advance Care Directives) Bill 2021 inserts provisions into the Guardianship and Administration Act 1995 (the Principal Act) to provide for the making and implementation of advance care directives in Tasmania. This legislation has been by the Parliament in 2021 and is subject to implementation.
Can an ACD be made on behalf of someone else?
An Advance Care Directive is a decision made about your care or medical treatment in advance, while you have capacity to make healthcare decisions. A guardian, enduring guardian, person responsible or a carer cannot make an Advance Care Directive on your behalf. As outlined above, an ACD is only valid if you had capacity for decision-making at the time it was made.
Limitations to medical treatment can also be recorded via a Medical Goals of Care plan. Medical Goals of Care help guide decisions about reasonable limitations to medical treatment (for example CPR or life sustaining treatment), and what the aims of your treatment are in a hospital setting. This is a form completed by a senior medical practitioner in the hospital (or your GP in the community) in consultation with you and, where appropriate, a family member or close other. You can ask your GP or specialist for further information.
Where can I go for more information?
For community members
The Tasmanian Health Service provides more information on Advanced Care Directives on their website
For Health Professionals
The Australian Centre for Health Law Research (https://end-of-life.qut.edu.au/)