Potential healthcare choices

You may need to make decisions about potential treatments if you are seriously ill or facing the end of life. Everyone's needs and experience will be different. We have provided some information that may help with aspects of your healthcare decision-making, however it is important to always consult with your healthcare team.

Life-sustaining measures

A life-sustaining measure is a proposed medical treatment that can save a person's life. This may include interventions such as:

  • cardiopulmonary resuscitation (CPR)
  • ventilation
  • artificial nutrition and hydration.

Consent is required to provide, or not provide, life-sustaining measures. If you do not have capacity your healthcare team will seek your substitute decision-maker(s) consent if they are considering withholding or withdrawing life-sustaining measures. Following discussions with your substitute decision-maker(s), treatment can be stopped if it is clear that the treatment is not what you would have wanted and is providing no benefit to you.

In exceptional circumstances, such as an acute emergency, all life-sustaining measures except for artificial nutrition and/or hydration may be withheld or withdrawn by a doctor without consent of a substitute decision-maker. This can only be done if the doctor is not aware of your previous objections, or if the doctor believes that to commence, or not commence, life-sustaining measures is consistent with good medical practice. Artificial nutrition and/or hydration may not be withheld or withdrawn in any circumstances without consent.

Resuscitation planning

Resuscitation planning refers to decisions made in advance about what to do in the event you stop breathing (respiratory arrest) or your heart stops (cardiac arrest).

In almost all cases, resuscitation planning will also involve making decisions about other life-sustaining measures.

If you are admitted to hospital and your doctor wishes to complete resuscitation planning, the following may be discussed with you and documented on your medical records:

  • options for resuscitation
  • what might happen if you are resuscitated
  • who your decision-maker(s) is if you lose capacity
  • your choices about resuscitation, including any objections
  • what medications and pain management might be involved.

Read more about the approach to acute resuscitation planning and clinical decision-making processes in Queensland Health facilities.

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Ambulance emergencies

Paramedics will perform resuscitation procedures in an emergency unless formal paperwork is in order refusing life-sustaining measures. Therefore, if you have strong wishes about not being resuscitated during an emergency, you should formalise your decision with an advance health directive or enduring power of attorney. The attending paramedics will need to view the paperwork, so it is important that it is readily accessible.

Refusing treatment

Making choices about the types of treatment you receive is a crucial part of healthcare decision-making. Just as important is the decision to discontinue or refuse treatment. Every person’s situation, experience of illness, goals of care and approach to care are unique.

Many factors influence the decision to discontinue or refuse treatment. A number of treatments and interventions can artificially extend life: certain medications, artificial nutrition, treatments such as dialysis, transfusions, radiation, and ventilation for breathing. It is important that patients and families understand the intent and possible risks or benefits of the care they are receiving.

While you have decision-making capacity, you have a legal right to discontinue or refuse treatment. You can do this even if it results in your death, and other people don't agree with or like your decision—for example, the healthcare team, your GP, family or friends.

If a doctor or healthcare professional has doubts about your capacity to make a decision they may need to assess you.

If you lose capacity, your substitute decision-maker(s) can express your wishes on your behalf, as long as you have made your wishes about potential medical treatment known.

The healthcare team must provide substitute decision-maker(s) with all the information they require to make an informed decision in your best interests.

If you feel particularly strongly about discontinuing or refusing medical treatment before you lose capacity, it is best to formalise this decision in an advance health directive or make your wishes well known to your substitute decision-maker(s) and your healthcare team.

Read more about capacity.

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Organ and tissue donation

After you die, organs and tissues can be removed from your body and transplanted into another living person to give them life or to improve their quality of life. Which organs and tissues you are able to donate depends on many factors such as why you died, your past medical history and where and when you die.

You can ensure your wishes regarding organ and tissue donation are respected by making sure your family, friends or substitute decision-maker(s) are aware of your plan. This can be included in advance care planning.

Learn more about organ and tissue donation.

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Spiritual or religious beliefs

If you have spiritual or religious beliefs that relate to medical treatments, it is important to express your views so they can be taken into account when you no longer have capacity. This can be done by discussing your beliefs and wishes with your substitute decision-maker(s), your healthcare team, or by recording your choices.

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Disclaimer

The information provided on these pages is general in nature and is not intended as legal advice. Healthcare decision-making scenarios will often be complex—you need to consider individual circumstances, and sometimes the level of detail and extra information required will mean you need to seek more advice. If you are in any doubt contact the Office of the Public Guardian, or seek legal advice.

Concerns about your healthcare

Second opinions

You may want to get a second opinion from another specialist to confirm or clarify your doctor’s recommendations or reassure you that you have explored all of your options.

Your doctor can refer you to another specialist and send your initial results to that person. You can get a second opinion even if you have started treatment or still want to be treated by your first doctor. You might decide you would prefer to be treated by the doctor who provided the second opinion.

Speak to your GP, doctor or healthcare team for more information.

Complaints and compliments

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