Advance Care Planning and Directives – why bother?
Why is everyone talking about Advance Care Planning and why is it important to have an Advance Care Directive?
Medical advances mean that the focus is on prolonging life wherever possible through medical intervention, and many people don’t realise that it is their right to refuse intervention. We’re not talking about euthanasia – we’re talking about the right to die naturally without having our lives prolonged artificially.
The types of medical interventions include resuscitation known as CPR: restarting the heart once it has stopped; artificial ventilation: having a machine breathe for you; artificial feeding: being given food and nutrients through a tube, and renal dialysis.
If we don’t want these interventions, how can we make sure we’re not given them?
If you are fully competent – that means you are able to think through and are aware of the consequences of your decisions and you can communicate these to your medical team, that’s what you do. However, Dr Karen Detering, the medical director of Advance Care Planning Australia says that at least half of us won’t be in a position to make our own decisions if we become unwell or have an accident.
So creating an Advance Care Plan and properly filling out an Advance Care Directive is important, because this is the document that the person acting on your behalf and your medical team will use to determine exactly what treatment to administer when you can’t communicate this for yourself.
What’s the difference between an Advance Care Plan and an Advance Care Directive?
An Advance Care Plan helps you to gain clarity on what type of medical assistance you do and do not want should you find yourself in hospital. An Advance Care Directive is the formal documentation that advises others of your treatment choices should you not be able to communicate these to your medical team.
When is an Advance Care Directive used?
Only when you can’t communicate your wishes to your medical team. When you write an Advance Care Directive you nominate a ‘person responsible’ or ‘substitute decision maker’ to represent your interests and they use the directive to negotiate with the medical team on your behalf.
Is an Advance Care Directive a legal document?
Unfortunately, in Australia the laws and forms currently differ from state to state and whilst in Victoria the Medical Treatment Planning and Decisions Act 2016 enshrines advance care directives in law, there is currently no law relating to advance care planning documents in other states. Usually though, health professionals are obliged to comply with the preferences stated in your Advance Care Directive and one filled in correctly and witnessed by a Justice of the Peace would likely guide treatment.
We’ll cover what you can do to formalise your Advance Care Directive in another article. The first step is to learn more about the importance of Advance Care Planning and start a conversation with your family, GP and medical team as soon as possible.
Go to https://www.advancecareplanning.org.au/ to find out more information about Advance Care Planning in your state or territory.