Advance care planning: start the conversation with loved ones today

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If you suddenly became seriously ill and were unable to communicate, would your family and doctors know what care or medical intervention you wanted? Would your loved ones argue and fallout over what they believed to be your wishes? Who would you want to speak on your behalf and what would you want them to say?

Next year legislation will come into force that changes the way Victorians determine the medical treatment they receive. The aim is to simplify, clarify and strengthen current practices via an Advance Care Directive. It will allow you to make legally binding decisions about future medical conditions. Presently, this can only be done for current medical conditions. The State Government is set to launch a public education program about the legislation. This will give you time to consider the issues carefully and have important discussions with your family and friends.


The Medical Treatment Planning and Decisions Act 2016 comes into effect on 12 March 2018. (This Act should not be confused with the Voluntary Assisted Dying Bill due to go before Parliament later this year.) The Act will provide certainty about the legal status of documents expressing your wishes, and will ensure health practitioners are clear about their obligations.

Currently, Australians can convey their medical treatment wishes to their loved ones and doctors in an Advance Care Plan (ACP). In Victoria, a free ACP template form can be downloaded from the Internet. It’s an easy way to document your healthcare choices formally, based on your personal values and beliefs.

What is an Advance Care Plan?

An ACP is not just for people who are ill or the elderly. Younger adults and children can unexpectedly experience an illness or injury where they are unable to convey their treatment wishes.
 
Advance care planning is having conversations with family, friends and your doctor about the medical care you want – or don’t want – should you become seriously ill or injured. It’s discussing your beliefs, values and healthcare preferences. This means your family is not left with the burden of guessing what is right for you in a crisis.
 
For example, if you wish to donate your organs, you should tell your family and friends and include it in your plan. Even if you are on the Australian Organ Donation Register, doctors are currently unable to proceed without your family’s consent. You can click here to register your decision to become an organ and tissue donor.
 
Advance Care Planning Australia is a national program that encourages people to think about their current and future health goals. The organisation says bereaved families of people with an ACP are more satisfied with care, and experience less anxiety and depression. An Advance Care Plan only comes into effect if you are unable to make decisions for yourself. At that time, your plan will guide your family and doctors.

How is an Advance Care Directive different?

When the new laws begin in March, you will be able to consent to or refuse medical treatment by making an instructional directive contained in an Advance Care Directive. This means you - or your appointed medical treatment decision maker - can consent to or refuse treatment for any future medical condition.

The legally binding Advance Care Directive will allow you to:

  • Make an instructional directive about your treatment preferences
  • Make a values directive to guide your appointed decision maker or doctors

You will also be able to appoint a:

  • Medical treatment decision maker to make decisions if you are not capable
  • Support person to assist you to understand the issues and communicate your decisions

 You can choose someone right now to make medical decisions for you by appointing a medical agent under an enduring power of attorney (medical treatment) or an attorney for personal matters with power to make decisions about healthcare treatment. These appointments will automatically become valid under the new Act when it begins.
 
You cannot make an Advance Care Directive until the new Act begins. However, you can make an Advance Care Plan today, outlining your medical treatment preferences and advising those close to you. From 12 March, you will be able update your existing ACP to an Advance Care Directive. Under the Act, your medical treatment decision maker will be legally required to make decisions in accordance with your values and preferences, including considering any ACP or Advance Care Directive you have made.
 
If this all sounds a little overwhelming or confusing, further information and support about making Advance Care Directives will be available when the Act begins. The important thing is to start have the conversations with your family today.

What can I do now?

  • Think about your values, beliefs and wishes for future care
  • Discuss them with those close to you
  • Consider appointing a Power of Attorney for medical treatment
  • Write your wishes down – use the ACP template
  • Give your plan to loved ones and your doctor
  • Review it regularly or when circumstances change
  • Consider making an Advance Care Directive next year

 An advance care plan is no substitute for a current will or medical power of attorney. Speak to your GP if you need advice regarding your Advance Care Plan or Advance Care Directive. And remember to give them a copy when it’s done. Mark March 12 in your diary.