How to set up an advance care directive

An advance care directive is a written record of the medical treatment you would and would not want if you could not speak for yourself. It is one of the kindest documents you can leave behind, because it takes the weight of impossible decisions off the shoulders of the people who love you.

What it can cover

• The treatments you would accept, refuse, or want stopped in specific situations.
• Your values and what quality of life means to you.
• Who you want to make decisions on your behalf.
• Where you would prefer to be cared for, and where you would prefer to die.
• Any cultural, religious, or spiritual practices that matter to you.

Who can make one

Any Australian adult with decision-making capacity can make an advance care directive. You do not need to be unwell or elderly. In fact, the best time to make one is when you are healthy enough to think clearly.

How it works in each state

The name and legal form differ across the country. Same idea, different paperwork.

• New South Wales: Advance Care Directive.
• Victoria: Advance Care Directive under the Medical Treatment Planning and Decisions Act.
• Queensland: Advance Health Directive.
• South Australia: Advance Care Directive (single form covering directives and substitute decision-makers).
• Western Australia: Advance Health Directive.
• Tasmania: no statutory form, but common-law directives are recognised.
• ACT: Health Direction.
• Northern Territory: Advance Personal Plan.

Start with the official form for your state or territory. Advance Care Planning Australia (advancecareplanning.org.au) has every form in one place.

Making it legally binding

1. Read the form for your state or territory carefully.
2. Talk to your GP so your wishes are medically sensible.
3. Talk to the person you want to appoint as your substitute decision-maker, and get their agreement.
4. Complete and sign the form, following the witnessing requirements for your state.
5. Give a copy to your GP, your substitute decision-maker, your hospital, and your family.
6. Upload a copy to My Health Record so any hospital in Australia can find it.

Review it regularly

Circumstances and views change. Review the directive every couple of years, or after any major diagnosis. Cross out the old version, sign the new one, and reissue it to everyone who holds a copy.

Where to keep it

The best place is My Health Record, because it is available to any Australian hospital 24 hours a day. The second-best place is with the person you have named as your substitute decision-maker. Do not lock it in a safe your family cannot open on a Sunday night.