Advanced Health Directives

An Advance Health Directive is a formal way of giving instructions for your future health care, and comes into effect only if you are unable to make your own decisions.

You can include relevant information about yourself that health professionals should know, such as: 

• special health conditions
• allergies to medications 
• religious, spiritual or cultural beliefs that could affect your care.

What it covers

An Advance Health Directive allows you to plan what medical treatment or health care you would like in the event that you cannot make decisions for yourself. It also enables you to appoint an attorney for health and personal matters if you want.

You can use your directive to express your wishes in a general way, such as stating that you would want to receive all available treatment. 

You are able to give specific instructions about certain medical treatments. For instance, you might feel strongly about whether or not you want to receive life-sustaining measures to prolong your life. These include:

• cardio-pulmonary resuscitation, to keep your heart beating
• assisted ventilation, to keep you breathing if your lungs stop working
• artificial nutrition and hydration.

You can use your directive to outline your views about the quality of life that would be acceptable to you. For instance, you might decide to specify that you would like life-sustaining measures withheld or withdrawn in certain situations, such as if you were to:

• have a terminal illness for which there is no known cure nor chance of you recovering 
• have severe and irreversible brain damage so that you are unable to communicate
• have an illness or injury so severe that there is no reasonable prospect that you will recover.

You can make an advance health directive if you are over 18 and have the capacity to do so. This means that 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
• communicate your decisions in some way.

The best time to make an advance health directive is now, before any urgent health condition arises. However, it is particularly important to make one if:

• you are 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 result in serious complications such as diabetes, asthma and heart or kidney disease.

You can download the form http://ag.ca.gov/consumers/pdf/AHCDS1.pdf for free, or you can buy one from a newsagency or some bookshops and stationers.

Part of the Advance Health Directive form needs to be completed by a doctor, so get them to explain your options, any unfamiliar terms, and ask them to provide more information if you need it.

Before completing the form, first take time to carefully reflect on the decisions you have to make. Remember, you are putting in place a plan that will determine your future health care.

Consider what is important to you. Discuss these matters with your family or close friends.

You will also need a witness, who is responsible for making sure that your signature is genuine, and that you understand the decisions you are making. Your witness must be over the age of 21 and be a Justice of the Peace, Commissioner for Declarations, lawyer or Notary Public. They cannot be:

• your attorney for personal matters
• your relative or a relative of your attorney
• a current health provider
• a current paid carer (this doesn’t include a person on a carer’s pension)
• a beneficiary under your will.

You don’t need to lodge your completed form with any authorities. Keep the original document in a safe place and give a copy to your doctor, a family member or friend, and your attorney for personal matters if you have one.

You might also want to carry a card stating that you have made an Advance Health Directive and where it can be found.

You can make changes to your Advance Health Directive at any time, provided you still have the decision-making capacity to do so. It’s a good idea to review your directive every two years, or if your health changes significantly.

You can also revoke your directive, which means you cancel your instructions. You need to make any changes in writing and have your signature witnessed.