Advance health directive

At some point in the future, you may be unable to make decisions about your health care, even temporarily. This might be due to an accident, dementia, a stroke or a mental illness.

An advance health directive allows you to:

• give directions about your future health care
• make your wishes known and give health professionals direction about the treatment you want
• appoint someone you trust (an attorney) to make decisions about health care on your behalf.

Making an advance health directive

Who can make an advance health directive

To make an advance health directive, you must be 18 or older and have capacity to understand the nature and effect of the advance health directive.

This means you need to understand:

• the nature and likely effects of each direction in your advance health directive
• that a direction operates only when you don’t have capacity to make decisions about your health care covered by the direction
• that you may revoke a direction at any time you have capacity to make a decision for the matter covered by the direction
• that at any time you don’t have capacity to revoke a direction, you will be unable to effectively oversee the implementation of the direction.

You must also be able to make the advance health directive freely and voluntarily—not due to pressure from someone else.

Your advance health directive must be signed by your doctor and by you in the presence of an eligible witness.

In signing the advance health directive, the doctor and witness are certifying that you appeared to have capacity to make the advance health directive.

To learn more about capacity to make an enduring power of attorney, see section 6 of the capacity assessment guidelines.

When to make an advance health directive

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 (e.g. diabetes, asthma and heart or kidney disease).

Preparing to make your advance health directive

Before you complete an advance health directive, read the advance health directive form and explanatory guide.

You should also:

• think about your views, wishes and preferences for your future health care
• talk to your family and friends
• talk to your doctor—they
  • will have access to your medical history
  • can help you understand how a particular illness may affect you
  • can discuss treatment options and the effects of those treatments
• if you plan to appoint an attorney for health matters, consider who you want to appoint and talk to them about it.

Accessing the form

You can download a free copy of the advance health directive form.

Paper copies are available to purchase from various newsagents and stationery suppliers throughout Queensland.

You can also print a copy at your local library or access a print on demand service.

Completing the document

Refer to the advance health directive explanatory guide while you complete the form. It steps you through each of the questions and will give you useful information, practical examples, hints and tips.

A doctor will need to complete part of the form, so you can ask them to explain your options and any unfamiliar terms. The doctor will assess your capacity to make the advance health directive and may charge a consultation fee.

After your doctor signs, you need to sign the form in the presence of one of these witnesses:

• a justice of the peace (JP)
• commissioner for declarations (Cdec)
• notary public
• lawyer.

While your eligible witness does not need to sign the form in front of the doctor, if you and the witness sign the advance health directive as soon as possible after the doctor signs it, this helps confirm your capacity to make the advance health directive.

If your advance health directive appoints an attorney(s) for health matters, your attorney(s) must sign the document to accept their appointment after you and the witness have signed the document. Your attorney(s) do not have to do this immediately; however, they must sign it before they can start making decisions on your behalf.

What to do with the completed form

You do not have to lodge or register your advance health directive anywhere once you have completed your advance health directive.

However, it is strongly recommended that you:

• keep the original in a safe place
• let your close family and friends know you have made an advance health directive and where to find it.
• give a certified copy to your attorney(s) (if appointed), doctor, other health provider(s), bank or lawyer. This may include your local hospital, where they may add it to your patient file

You could also carry a card that states you have made an advance health directive and where to find it.

You should review your advance health directive at least every 2 years, or if your health changes significantly.

Cancelling your advance health directive

You may revoke (cancel) your advance health directive at any time you have the capacity to do so.

You do not have to complete a specific form to revoke (cancel) your advance health directive; however, any revocation must be in writing and you must take all reasonable steps to advise any attorney(s) (if appointed) that it has been revoked.

To learn about other circumstances when your advance health directive may be revoked or cancelled, see page 19 of the explanatory guide.

What an attorney must do

An attorney has important legal duties and obligations that they must comply with.

It is strongly recommended that a person seeks advice from a professional (e.g. a lawyer) when considering whether to accept appointment as an attorney.

These factsheets explain more about the duties and obligations of attorneys in Queensland:

• Obligations of attorneys under an enduring document
• General and health care principles under our guardianship framework

More information can also be found on pages 22–24 of the advance health directive explanatory guide.

If you do not have an advance health directive

A statutory health attorney may make health care decisions on your behalf if you have not:

• made an advance health directive
• appointed an attorney for health care matters under an advance health directive or an attorney for personal (including health care) matters under an enduring power of attorney
• had a guardian appointed for health care matters by the Queensland Civil and Administrative Tribunal (QCAT).

Statutory health attorney

Your statutory health attorney is the first person, in this order of priority, who is 18 or older, readily available and culturally appropriate to exercise power for a health matter:

1. Your spouse (including a de facto partner and/or civil partner) who is in a close and continuing relationship with you
2. Your carer (who is not your paid carer, health provider or service provider for a residential service where you are a resident)
3. A close friend or relation who is in a close relationship with you (who is not your paid carer, health provider or service provider for a residential service where you are a resident)

If no one is readily available or culturally appropriate, 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
• sterilisation
• 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

A statutory health attorney must apply the general principles and health care principles when making decisions about health matters or special health matters for you.

Learn more about the general and health care principles under our guardianship framework.

The statutory health attorney’s authority ends if you regain the capacity to make decisions. The role is not necessarily ongoing.

More information

• Advance health directive form
• Advance health directive explanatory guide
• Queensland capacity assessment guidelines
• Frequently asked questions—new enduring power of attorney and advance health directive forms
• Factsheet—general principles and health care principles under Queensland's guardianship framework