Advance Care Planning

Contributed by Katie Binstock, McInnes Wilson Lawyers and current to March 2018

Advance care planning is a series of steps that can be taken to plan future health care. The aim of advance care planning is to promote autonomy and dignity.

There are three documents in which people can record health care choices:

1. Enduring Power of Attorney (a legal document);
2. Advance Care Plan Statement of Choices (non-legal document); and
3. Health Directive (a legal document).

Enduring Powers of Attorney are governed by the Powers of Attorney Act 2006 (ACT).

Advance Care Plan Statement of Choices and Health Directive are governed by the Medical Treatment (Health Directions) Act 2006 (ACT).

Canberra residents can send copies of their Advance Care Plan documents to the ACT Health Respecting Patient Choices Advance Care Plan Program. They will be scanned and placed on the residents’ electronic medical record at the Canberra Hospital.

Enduring Powers of Attorney

An Enduring Power of Attorney is the legal document that gives a decision maker (the Attorney) the legal authority to act for a person (the Principal) and to make legally binding decisions on the Principal’s behalf (see Enduring Powers of Attorney).

Advance Care Plans and Health Directions are optional documents and can provide additional directions to the Attorney. If the directions are inconsistent, the Attorney is bound by the most recent document.

The Principal can also insert any directions, limitations or conditions in relation to health care matters in the Enduring Power of Attorney.

Advance Care Plan Statement of Choices

An Advance Care Plan records a person’s wishes and values regarding future medical treatments. It provides the chosen decision makers and doctors with information for treatment if a person is no longer able to make decisions. An Advance Care Plan can deal with:

• what ‘living well’ or an acceptable recovery/reasonable outcome means;
• choices about life prolonging treatment;
• choices about CPR;
• requests about medical treatments;
• people to be included in decisions about healthcare; and/or
• things that are important when nearing death (e.g. care of a pet, religious or spiritual rituals, cultural customs, messages for family and friends).

Because an Advance Care plan is not a legally binding document, people with impaired decision-making capacity can still make Advance Care Plans.

Health Direction

A Health Direction allows a person to legally direct their Attorney in relation to their future health care decisions. For example, a Health Direction can require an Attorney to refuse, withhold or withdraw treatment of a particular kind.