Advance health directive
An advance health directive (AHD)—sometimes called a living will—is a formal way to give instructions about your future health care. It comes into effect only if your cognitive health deteriorates and you become unable to make your own decisions (i.e. lose capacity to make decisions).
What an AHD includes
An advance health directive:
- outlines what medical treatment or health care you want if you can no longer make decisions for yourself. It can be general (e.g. that you wish to receive all available treatment) or specific (e.g. that you wish to decline a certain medical treatment)
- enables you to appoint an attorney for health and personal matters
- includes information that health professionals should know, including health conditions, allergies, and religious, spiritual or cultural beliefs that could affect your care.
In your AHD, you can give specific instructions about certain medical treatments, such as whether you want to receive life-sustaining measures—such as tube feeding or resuscitation—to prolong your life.
You can also outline the quality of life that would be acceptable to you. For example, you might ask that life-sustaining measures be withheld or withdrawn if you have:
- a terminal illness with no known cure or chance of recovery
- severe and irreversible brain damage, and you can’t communicate
- a severe illness or injury that you’ll probably never recover from.
Who can make an AHD
You can make an advance health directive if you’re over 18 and have the capacity to do so, meaning you:
- understand the nature and consequences of your health care decisions
- understand the nature and effect of the directive
- freely and voluntarily make these decisions
- can communicate your decisions in some way.
When to make an AHD
The best time to make an advance health directive is now, before any urgent health condition arises. However, it’s particularly important to make one if:
- you’re about to be admitted to hospital
- your medical condition is likely to affect your ability to make decisions
- you have a chronic medical condition that could cause serious complications, such as diabetes, asthma and heart or kidney disease.
How to make an AHD
Before completing the form, carefully reflect on the decisions you have to make. Consider what’s important to you and discuss these matters with your family or close friends.
You can print and complete the advance health directive form or buy one from a newsagency or other private businesses across the state (e.g. bookshops and stationers).
A doctor will need to complete part of the AHD form, so you can ask them to explain your options and any unfamiliar terms. The doctor may charge a consultation fee for completing an AHD.
You’ll also need a witness who is a justice of the peace or commissioner for declarations, lawyer or notary public.
Your witness can not be:
- your attorney for personal matters
- your relative or a relative of your attorney
- a current health provider
- a current paid carer (which does not include a person on a carer’s pension)
- a beneficiary of your will.
Note: The requirement to have a witness also applies to powers of attorney.
Read more about making a power of attorney.
What to do with the completed form
You don’t need to lodge your completed AHD form with any authorities. Keep the original document in a safe place and give a copy to your doctor, a family member or a friend, and your attorney for personal matters if you have one.
You could also carry a card stating that you’ve made an advance health directive and where it’s located.
Changing or revoking a directive
You can change or cancel your AHD at any time if you still have the decision-making capacity to do so. Review your directive every 2 years or if your health deteriorates.
Make all changes in writing and have them witnessed.
If you don’t have an AHD
A statutory health attorney can be appointed to make health care decisions on your behalf if you can’t make decisions yourself and you haven’t:
- made an advance health directive
- appointed an attorney for personal matters under an enduring power of attorney or advance health directive
- had a guardian appointed for health care matters by the Queensland Civil and Administrative Tribunal (QCAT).
They can consent to medical treatment or an operation while you’re unconscious. They can also make decisions if you have an intellectual disability, dementia or an acquired brain injury.
Who may act as a statutory health attorney?
A statutory health attorney usually has a close relationship with the impaired adult, such as a spouse, de facto partner, primary carer (not paid), friend or relative.
If no one is suitable or available, the Public Guardian acts as the statutory health attorney as a last resort.
Decisions a statutory health attorney can make
A statutory health attorney can consent to most health care decisions, including withdrawing and withholding life-sustaining measures.
A statutory health attorney can’t consent to forensic examinations or special health matters, such as:
- tissue donation
- pregnancy termination
- special medical research or experimental health care.
Only QCAT can give consent for these special health matters.
Responsibilities of a statutory health attorney
All health decisions made for an adult must maintain or promote their health and well-being, and be in their best interests.
Therefore, a statutory health attorney must:
- choose the least intrusive treatment available
- consider the adult’s views and wishes where possible
- consider a doctor’s opinion.
The statutory health attorney’s authority ends if you regain the capacity to make decisions. The role is not necessarily ongoing.