Advance Care Directives
All competent adults have a right to decide what medical treatment they would refuse if they lose capacity to make decisions in the future. This Course looks at the increasing trend to have future refusals of treatment recorded in legally binding documents known as Advance Care Directives (ACDs).
StateState the purpose of an Advance Care Directive
IdentifyIdentify the legal requirements of a valid Advance Care Directive
DescribeDescribe common dilemmas associated with refusal of treatment instructions
Dr Linda Starr is a general and mental health qualified nurse, lawyer, and associate professor in the School of Nursing and Midwifery at Flinders University. Her research interests have been in health law for health practitioners, criminal law, forensic health care, and elder abuse investigation and prosecution, which was the subject of her PhD. Linda is currently the chair of the state board of the Nursing and Midwifery Board, Australia, the director on the Board of Directors at the Aged Rights Advocacy Service, and is the founding president of the Australian Forensic Nurses Association. She has an extensive speaking record, nationally and internationally, on issues in health law, forensic nursing, and elder abuse.
- What is an Advanced Care Directive?
- Requirements for a valid Advanced Care Directive
- Substitute decision making
- Case law and Advanced Care Directives
All health professionals working in all contexts of adult health care.
Gain a better understanding of the legal framework that supports a competent adult to make decisions about health care they would be prepared to accept or refuse at some time in the future, should they lose capacity to make these decisions at the time.
All adults have the right to make decisions about their own body. This includes the right to consent and to refuse treatment – even if refusal of treatment will cause their death. The right to refuse treatment in advance has also been upheld by the common law. There is a growing trend to have future refusals of treatment recorded in legally binding documents such as an ‘Advance Directive’ or ‘Living Will’. For this document to be valid an individual who has done so freely must create it and have the legal competence to do so. Should health practitioners ignore these instructions or provide treatment that is contrary to a person’s wishes they could leave themselves open to civil and perhaps even criminal prosecution. However, it is also important to understand the legal requirements of a valid document including the absence of ambiguity, completeness, witnessing by an appropriate witness and what key terms mean to enable the health practitioner to determine if the document has any defects that would make implementing the patient’s wishes difficult. Therefore, it is imperative that all health practitioners understand what constitutes a valid refusal of treatment through these written instructions to meet their common law and professional obligations when providing care for their clients.
Health professionals in Australia that are registered with AHPRA are required to obtain continuing professional development (CPD) hours/points each year that relates to their context of practice, in order to comply with mandatory regulatory requirements.