Advance Care Planning is planning ahead for your future healthcare, in case you are ever too ill to speak for yourself.
Who would speak for you and make medical decisions for you and would that person know what you would want?
Advance Care Planning in 3-Steps
This is a way to remember the steps involved.
Note: If you live in Victoria, you need to complete Victorian forms as these vary between states.
Note: This information applies only to adults. Children under the age of 18 can complete an Advance Care Directive but the requirements are different. Please consult your Paediatrician.
A person with capacity (ability) can appoint a Medical Treatment Decision Maker to make decisions on their behalf, if/when they lose the ability to make decisions for themselves.
The role of the Medical Treatment Decision Maker is to make, as best they can, the same decision the person would make for themselves.
- They should consent to treatment they believe you would want
- They should refuse treatment they believe you would not want
If you do not appoint a Medical Treatment Decision Maker, Victorian law provides a list of who your Medical Treatment Decision Maker would be.
Medical Treatment Decision Maker Hierarchy
- The appointed Medical Treatment Decision Maker (MTDM).
- Guardian appointed by VCAT who has the power under that appointment to make medical treatment decisions.
- First of the following who is in a close & continuing relationship:
- the spouse or domestic partner of the patient
- the primary carer of the patient
- an adult child of the patient
- a parent of the patient
- an adult sibling of the patient.
*If more than one person in the same position, the eldest is the MTDM
Talk with others about what you would want them to know if medical decisions needed to be made for you:
- Your Medical Treatment Decision Maker
- Your family and friends
- Your General Practitioner, Specialist, Palliative Care team or others involved in your care
- You may also have questions for your faith leader or priest
You can also complete an Advance Care Directive form.
This is one form in two parts:
Values Directive: this is information about the things that are important to you, and that you would want your Medical Treatment Decision Maker to take into account when making decisions for you.
Instructional Directive: this provides instructions to your doctor and other health professions. Here, you can consent to particular treatments and/or refuse particular treatments.
- This consent or refusal legally binds health professionals to follow your instructions.
Note: Because an Advance Care Directive is only used when a person loses capacity to make their own medical decisions, it is not a mechanism to request Voluntary Assisted Dying, which requires the person to have capacity at the time.
What if a person doesn’t wish to do advance care planning?
Not everyone will wish to engage in Advance Care Planning and it is not compulsory. Some people find it easier not to look too far into the future.
Many people will be willing to do Advance Care Planning to help their family, even if they don’t see a great need to do it for themselves.
Advance Care Planning can be done by people of all ages and health conditions. It is not just for people who are approaching the end of their life. Sometimes, fit and healthy people become suddenly ill or injured and it is then too late to be doing Advance Care Planning.
This video about advance care planning and preparing for decisions at a time of dying describes one situation when advance care planning can be helpful. Please note that the image of an advance care planning document shown in this film is no longer in use.
Who should particularly think about completing advance care planning documents?
1. Appointing a Medical Treatment Decision Maker
- Those who will not have a non-appointed Medical Treatment decision maker.
- Those who prefer to have someone other than their non-appointed Medical Treatment Decision Maker to make their medical treatment decisions.
- Those for whom it is unclear who their Medical Treatment Decision Maker would be.
2. Completing an Advance Care Directive
- Those who have very strong views about treatments they would not want in the future
- Those who will not have a Medical Treatment Decision Maker when they can no longer make their own medical decisions – their written Advance Care Directive will be their voice
- Those who have different views to their family members about medical treatment; an Advance Care Directive helps make their preferences and values clear. It also helps their Medical Treatment Decision Maker confidently advocate for what the person wants.
- Those who have a disability that might make engaging in medical decisions difficult but may still be able to make their own decisions if given support. The Advance Care Directive can explain who they need to have as a Support Person to help them make decisions and how the person with a disability needs information to be provided.
Appointing a Support Person
Many people have an informal support person who attends medical appointments, listens to what the health professional says, and helps the person think through their medical decisions.
It is also possible to appoint a Support Person. The Support Person’s role is to assist the person with medical decision-making capacity to make their own decisions. The Support Person does not have authority to make medical decisions for the person. The Support Person also has authority to access any medical information that the person themselves is able to access, such as test results.
The person who hasn’t done advance care planning and no longer has capacity to do this
If a person does not have the capacity (ability) to complete an Advance Care Directive, others who know them well can complete a form, ‘What I understand to be the person’s preferences and values’.
This is a way for the Medical Treatment Decision Maker and others to reflect upon what they already know about the person that would be important if medical decisions needed to be made. This knowledge can be gained from what the person has said, how they have made other decisions or how they have lived their lives.
Doing this before decisions need to be made can be helpful for the Medical Treatment Decision Maker and others to be better prepared if they need to make an urgent decision, when it is not easy to think so clearly.
Further information is available for Medical Treatment Decision Makers in a guide from the Office of the Public Advocate (Vic)
Further Advance Care Planning Information:
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