Advance Care Directives

An Advance Care Directive typically covers several important aspects of your preferences for future care:

1. Personal Values and Priorities: Your views on what makes life meaningful, including relationships, independence, and religious beliefs.
2. Undesirable Outcomes: Situations you wish to avoid, such as prolonged life support without recognition of loved ones or being in a coma.
3. End-of-Life Wishes: Preferences regarding the location of your passing, the presence of certain people, religious practices and organ donation.
4. Living Arrangements: Your preferences about staying at home or moving into supported care.
5. Healthcare Preferences: Types of medical and emergency care you wish to receive or avoid, including life-sustaining treatments.
6. Other Personal Considerations: Cultural, spiritual, lifestyle , and even smaller personal care preferences.

This directive ensures your wishes are respected even when you might not be able to communicate them yourself.

In an Advance Care Directive, you have the right to include a legally binding refusal of certain medical treatments.

This means that your healthcare providers and Substitute Decision-Makers must respect your wishes as specified. For example, you may choose to refuse life support if you are in a coma or a persistent vegetative state. It is important to clearly outline these situations in your directive.

However, please note that this does not extend to refusing compulsory mental health treatments if mandated by a community or involuntary treatment order.

A Substitute Decision-Maker is an individual over 18 years old whom you designate to make decisions on your behalf regarding your health care, end-of-life care, living arrangements, and personal matters if you are unable to do so yourself. 

This person is required to make decisions they believe you would have made under the same circumstances. It is important to note that a Substitute Decision-Maker does not have the authority to make legal or financial decisions for you; such decisions require an Enduring Power of Attorney.

To appoint a Substitute Decision-Maker, it is crucial to select an adult who you trust to handle decisions about your healthcare, end-of-life care, living arrangements, and personal matters if you become unable to make these decisions yourself.

It is always a good idea to speak with the person that you are thinking of appointing as a substitute decision maker before having the document prepared.

It is important to note that Substitute Decision-Makers are not authorised to make legal or financial decisions on your behalf; these areas require an Enduring Power of Attorney.

In South Australia, any person who meets the following criteria can create an Advance Care Directive:

• Must be at least 18 years old;
• Understands what an Advance Care Directive is;
• Understands its purpose and uses;
• Knows when it will be used; and
• Has not been pressured into making an Advance Care Directive by any third party

An Advance Care Directive allows you to outline various personal preferences and instructions, including:

• Values and priorities concerning your life and health, such as maintaining relationships, independence, and religious beliefs.
• Specific healthcare outcomes you wish to avoid, like life-prolonging treatment under certain conditions.
• Preferences regarding end-of-life care, including where and how you wish to die, details about organ donation and funeral arrangements.
• Choices about where you would prefer to live, whether at home or in supported care.
• Types of preferred healthcare and treatments, and other personal considerations related to your lifestyle and daily activities.

An Advance Care Directive becomes effective when you are determined by a medical professional to no longer be able to make decisions for yourself. This ensures that your specified preferences and instructions are followed when you are no longer able to make decisions for yourself.

An Advance Care Directive terminates in the following three situations:

1. if you revoke it by signing a new ACD while still of sound mind; or
2. if you have inserted an expiry date in the ACD; or
3. or upon your death, at which point your Will takes effect.