The information in this section is taken in part directly from the standard Advance Health Directive form.
What is an Advance Health Directive? An Advance Health Directive is a document in which you give instructions about your future health care.
It comes into effect only if you are unable to make your own decisions.
Why should you make such a directive?People who are seriously ill, are often unconscious, or otherwise unable to communicate their wishes - at the very time when many critical decisions need to be made. So it's wise to make your wishes known before this happens.
When should you make one?The best time to make an Advance Health Directive is now, before any urgent matters arise.
However, it's particularly important to do so if you are about to be admitted to hospital, or if you have a medical condition that is likely, at some stage, to affect your ability to make decisions.
How does it work?
- You fill out a form stating what type of treatment you wish to have or not have. This may be a general statement of your wishes and/or may give specific direction for various medical conditions and types of treatment.
- You keep the form in a safe place, and you give a copy to other people who are likely to be involved, particularly your family, your doctor and hospital staff.
- Medical staff can refer to it when you become so ill that you can no longer make decisions for yourself.
If the directions in the form are inadequate for any reason, and you have not already appointed an attorney for personal/health matters, the Advance Health Directive form allows you to authorise an attorney to make health-care decisions on your behalf.
What happens if you do not make an Advance Health Directive and become so ill that you can't speak for yourself?You would have no way of making your wishes known.
Decisions about your treatment would be made by your attorney for personal/health matters (if you have one) or your statutory health attorney. Your statutory health attorney is someone close to you who would become your attorney "by default" (that is, the person your doctor would ask to make decisions for you). The law sets down in general terms whom that would be; it must be someone readily available who would be expected to take the responsibility. That person could be:-
- your spouse, where the relationship is close and continuing;
- your carer - the person primarily responsible for caring for you at home; or
- a close friend or relation.
Just who it would be depends not only on who is closest to you, but also on your culture or religion. For example, if you belong to a culture or religion where a particular person traditionally has authority, it may be more appropriate for that person to become your statutory health attorney, even if someone else usually cares for you.
Can anyone make an Advance Health Directive?Yes, anyone over the age of eighteen who is capable of understanding the nature and effect of their health-care decisions can make an Advance Health Directive.
What issues can I cover in this directive?
- You can give general directions. For example, you can mention:-
- Any particular treatment you would not wish to have;
- any special medical conditions that your health-care providers should know about, such as diabetes or an allergy to certain medications;
- any religious beliefs that could affect your treatment.
- You can give directions about what treatment you want or don't want if it turns out that your condition is:-
- terminal (you are unlikely to survive for longer than 12 months);
- incurable (there is no known cure);
- irreversible (there is no possibility that you will recover);
- likely to leave you in a condition you would find unacceptable, such as permanent loss of the ability to think or communicate with others.
- You can consider various medical conditions, such as coma or severe brain damage, and explain whether you would want particular types of medical intervention to keep you alive, such as:-
- emergency measures to keep your heart beating and your lungs working when they have stopped;
- a machine to keep you breathing;
- artificial feeding.
For example, if you are in a coma and there is no chance that you will regain consciousness, you may not want medical staff to use heart massage or electrical stimulation to keep your heart pumping.
- You can add any other matters that have not already been covered.
- You can authorise your attorney for personal/health matters to make decisions about any health-care issues that you haven't mentioned explicitly. (If you don't have an attorney for personal/health matters, you can use the Advance Health Directive form to appoint one; you just complete the section called "Appointing an attorney for personal/health matters".)
If you don't appoint an attorney for personal/health matters, such decisions would be made by your statutory health attorney, if there is someone to take on that responsibility, or by the Adult Guardian.
Note: You cannot give anyone else the authority to decide when to withdraw or withhold life-sustaining medical treatment (that is, treatment designed to keep you technically alive). You are the only person who can give such directions. You may only do so in an Advance Health Directive.
Does this mean that you can give instruction for your doctor to help you die?No. Euthanasia is illegal in Queensland. By law, your doctor cannot give you anything, such as an injection or an overdose of painkiller, to hasten your death.
In your directive you can ask to be given only palliative care if you are in the last stages of an incurable illness. This is treatment that is not aimed at a cure or at keeping you alive at any cost, but at ensuring that you are kept as comfortable and pain-free as possible.
What should you consider before making an Advance Health Directive?You should think carefully about what you want your medical treatment to achieve if you become very ill. For example:
- If treatment could prolong your life, what level of quality of life would you find acceptable?
- How much suffering would you accept in the hope that medical science would eventually cure or relieve your condition?
Where can you get help with your Advance Health Directive?The best person to discuss it with is your doctor - there is a section of the form that must be completed by a doctor. Ideally, your doctor will be involved in the whole process. In particular, your doctor can explain any medical terms that you are unsure about.
It is also important that you discuss the directive with your family and your attorney/s for personal/health matters.
Who else is involved in completing the form?Besides you and your doctor, there must be a witness.
Your witness must be:-
- aged twenty-one or over; and
- a justice of the peace, commissioner for declarations, lawyer or notary public.
Your witness must not be:-
- Your attorney for personal/health matters; or
- a relation of yours or of your attorney; or
- a current health-care provider; or
- a current paid carer.
(Note: A "paid carer" is someone, such as a nurse, who is paid a fee or wage to care for you, not someone receiving a carer's pension or similar benefit.)
The role of the witness is very important; it involves much more than making sure your signature is genuine. He/she must also state that you appear to understand the decisions you have made in the directive. If the witness is in any doubt about this, then he/she is not allowed by law to witness the document.
If you are using this form to give someone an enduring power of attorney for personal/health matters, that attorney will also have to sign the form.
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