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What is an Advance Care Directive?
An Advance Care Directive is made when a person specifies their wishes about future health care and medical treatment, including treatment at the end of life. A Directive can be followed only when a person no longer has decision-making capacity, and the direction relates to the medical treatment or health care situation that has arisen.
What does an Advance Care Directive cover?
You can include any information that is important to you about your values, wishes, beliefs and things that are important for your quality of life. This might include your spiritual, religious or cultural beliefs, practices or requirements, your preferred place of care, your preferred place to die, and any other things that give your life meaning.
If you identify as Aboriginal and / or Torres Strait Islander, you have an opportunity to state what else is important to you. This information can be used to guide your overall care.
You can nominate any specific health care and treatments you do not want, and in which circumstances you refuse this treatment. You should provide very clear instructions.
When will an Advanced Care Directive be valid?
To make a valid Advance Care Directive a person must:
- Be competent.
This means the person has capacity to make the Directive, and is able to communicate the decision that he or she is making about treatment.
- Make the decision voluntarily.
This means that the person cannot be forced or tricked into making an Advanced Care Directive.
An Advance Care Directive can be made orally or in writing. There is no legal requirement when making the Advance Care Directive that the person receive information about the treatment that he or she is requesting or refusing, or about the medical condition (if any) that the Advance Directive provides instructions about.
A direction may be given for any reason, whether religious, social or moral, or on any other grounds.
When a person loses capacity and a treatment decision is needed, their Directive can only be followed if it applies to the medical treatment or health care situation that has arisen.
When will an Advanced Care Directive not apply?
An Advance Care Directive will not apply if:
- The person’s circumstances have changed since the Directive was first given, so that the person would not have intended it to apply to the current situation.
An example of this is where, at the time a person made a Directive she or he was a Jehovah’s Witness and refused blood transfusions. However by the time a decision has to be made about treatment, the person has changed religion or renounced the Jehovah’s Witness faith. This may be a change of circumstances which would make the person’s Directive inapplicable to the situation.
- The terms of the Directive are uncertain or are ambiguous.
For example, in a Directive a person refuses ‘heroic measures’, but not does not state what sort of medical treatment he or she would consider a ‘heroic measure’.
Any Advance Care Directive should be clear and certain as to what treatment the person wants to refuse or accept in the future.
- The Directive was based on incorrect information or the person made an incorrect assumption.
For example, a person refuses specific treatment, such as a blood transfusion, wrongly believing that other medical treatment will be an effective alternative (such as an alternative non-blood product).
- The person is requesting treatment that is futile or non-beneficial.
A health professional can also refuse to follow an Advance Care Directive requesting treatment if the health professional believes that treatment is futile or non-beneficial. In those circumstances, the health professional cannot be required to provide treatment.
Has the law recently changed?
In November 2021 the Tasmania Parliament passed new laws about Advance Care Directives. These new laws support Tasmanian’s making Advance Care Directives and formalises the existing laws as explained above but are yet to come into effect.
Need more information?
Further information can be found on the Tasmania Health service website.
The Tasmania Health Service has an Advanced Care Directive Form.