11 Commonly Asked Questions About an Advance Health Directive in Queensland

Life can change in an instant. An accident or sudden illness could leave you unable to communicate your healthcare wishes. In Queensland, an Advance Health Directive (AHD) ensures your voice is heard even when you can’t speak for yourself. This legally binding document protects your rights, guides your care, and spares your loved ones from making difficult decisions without clear direction.

Despite its importance, only 14% of older Australians have a legally binding directive, according to a 2021 study in Health Expectations. So, do you need one? In this article, we’ll answer that question and address other common concerns about Advance Health Directives.

What Exactly is an Advance Health Directive?

An advance health directive in Queensland is a legal document that allows you to make decisions about your future medical treatment in advance. Created under section 35 of the Powers of Attorney Act 1998 and supported by Section 35 of the Guardianship and Administration Act 2000, this powerful document comes into effect only when you lose capacity to make or communicate decisions.

Even in circumstances when you cannot speak for yourself, an advance health directive allows you to:

• Provide specific instructions about medical treatments you consent to or refuse
• Document your personal values and preferences regarding healthcare
• Appoint one or more trusted individuals (attorneys) to make health decisions on your behalf
• Outline your wishes for end-of-life care

Unlike casual conversations with family members about "what you would want," an advance health directive Queensland health professionals must follow is legally binding (with certain specific exceptions). This means your documented wishes take precedence over what others might think is best for you. However, health professionals may not follow a directive if it conflicts with good medical practice or if circumstances have significantly changed.

Why Should You Consider Creating an Advance Health Directive?

Many people put off creating an AHD, thinking, "I'm healthy now" or "My family knows what I would want." However, there are compelling reasons why everyone should consider this important document:

Protection of your autonomy. An advance health directive ensures your preferences are respected even when you cannot advocate for yourself. Without one, decisions about your care may be made by doctors or family members who, despite good intentions, might not choose what you would have wanted.

Relief for your loved ones. Making healthcare decisions for someone else is an enormous emotional burden. By clearly documenting your wishes in an advance health directive, you spare your family the distress of guessing what you would want during an already difficult time.

Prevention of family conflict. When healthcare preferences aren't clearly documented, disagreements among family members about what you would want can create lasting rifts at an already stressful time.

Guidance for healthcare providers. Medical professionals want to respect patients' wishes, but without clear documentation, they may have to make difficult decisions based on limited information. An advance health directive provides clear guidance.

Peace of mind. Perhaps most importantly, creating an advance health directive in Queensland gives you confidence that your wishes will be respected, regardless of what happens in the future.

How Does an Advance Health Directive Work?

An advance health directive only becomes active when you lose capacity to make or communicate decisions. Until that point, you continue making your own healthcare choices directly.

Here's how it works:

• You create and sign your advance health directive with proper witnesses and doctor certification
• You distribute copies to relevant people
• If you later become unable to make decisions, healthcare providers refer to your directive
• Your documented instructions guide your care, with exceptions only in specific circumstances

It's important to understand that healthcare providers must follow your advance health directive unless:

• Circumstances have changed significantly since you wrote it, such that you would no longer consider your instructions appropriate
• Your instructions conflict with good medical practice
• A court or tribunal has ordered otherwise

For an advance health directive Queensland health systems will recognise, you must use the approved form and have it properly witnessed and certified.

When Should I Start Thinking About an Advance Health Directive?

The best time to create an advance health directive is before you need one. While many associate these documents with old age or terminal illness, unexpected accidents or medical emergencies can happen to anyone at any age.

You should consider creating an advance health directive if:

• You're over 18 years old and have decision-making capacity
• You're about to undergo a significant medical procedure
• You've been diagnosed with a condition that could eventually affect your cognitive abilities
• You have strong views about certain medical treatments
• You want to ensure your cultural, religious, or personal values inform your healthcare

Remember, creating an advance health directive doesn't mean you expect something bad to happen soon. Rather, it's a responsible step in planning for the unexpected—similar to having insurance or a Will.

Who is Responsible for My Advance Health Directive?

Creating and managing an advance health directive involves several parties:

• You have primary responsibility for creating your directive, ensuring it reflects your true wishes, and reviewing it periodically to keep it current.
• Your doctor plays a crucial role in discussing the medical aspects of your directive and certifying that you have the capacity to make the decisions contained within it.
• An eligible witness (typically a Justice of the Peace, Commissioner for Declarations, lawyer, or notary public) must witness your signature and certify that you appear to have the capacity to make the directive.
• Your appointed attorney(s) (if any) become responsible for making health decisions according to your wishes when you cannot do so yourself.
• Healthcare providers become responsible for following your directive when providing treatment after you lose capacity.

To ensure your advance health directive is accessible when needed, you should provide copies to your GP, specialists, local hospital, appointed attorneys, and close family members. Some people also carry a card in their wallet indicating that they have an advance health directive and where to find it.

How is an Advance Health Directive Different from an End-of-Life Care Plan?

People often confuse advance health directives with end-of-life care plans, but they serve different purposes: