An Advance Care Directive

The new Advance Care Directive Form which came into effect on the 1st July 2014 replaces the existing Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form.

Quoting from the S.A. Government web site;
“At some point in your life, there may come a time when you are unable to make a decision. It could be because:
• of a sudden accident or serious mental health episode
• of dementia or similar condition
• of a sudden serious stroke
• you are unconscious or in a coma.

If this happened, how would you want decisions to be made for you about your health care, living arrangements and other personal matters?
More importantly, who would you want making these decisions for you?
This Advance Care Directive will make it easy for others to know what your wishes are when you are unable to make these decisions yourself. It can also give you peace of mind to know that your wishes are known and will be respected, if others need to make decisions for you.
What is the new Advance Care Directive?
The new Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters.
The new Advance Care Directive allows you to:
• write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters and/or
• appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.
The role of the Substitute Decision-Maker.
As a Substitute Decision-Maker you must try to make a decision you believe the person would have made for themselves in the same situation.
As a Substitute Decision-Maker you can make all the decisions the person wanted you to make, but you cannot:
• Make a decision which would be illegal, such as requesting voluntary euthanasia.
• Refuse food and water to be given to them by mouth.
• Refuse medicine for pain or distress (for example palliative care).
• Make legal or financial decisions (unless you have also been appointed as an Enduring Power of Attorney for financial matters).
When contacted and asked to make a decision, you must:
• Support that person to make their own decision if they are able to.
• Produce an original or certified copy of the person’s Advance Care Directive Form or advise if it can be accessed in an electronic record.
• Only make decisions which you have been appointed to make under Part 2b Conditions of Appointment.
• Try to contact any other Substitute Decision-Maker appointed to make the same types of decisions as you.
• Only make a decision on your own if no other Substitute Decision-Maker with the same decision-making responsibility as you, cannot be contacted, or the decision is urgent.
• Inform any other Substitute Decision- Maker(s) of the decisions you make.
• Try to make a decision you believe the person would have made in the same circumstance.

What the Advance Care Directive is not.
This Advance Care Directive is not a Will. It also cannot be used to make financial or legal decisions. It is recommended you think about appointing an Enduring Power of Attorney to make decisions about your future finances and legal matters. Please refer to ‘Where I can get more information’ at the end of this Guide.
Who can write an Advance Care Directive?
You can write an Advance Care Directive at any stage of life – whether you are young, older, healthy or unwell. To write an Advance Care Directive, it must be your choice and you must:
• be 18 years old or over
• know what an Advance Care Directive is
• know what it will be used for and,
• know when it will be used.

What if I have other documents in place?
If you have already completed an Enduring Power of Guardianship, a Medical Power of Attorney or an Anticipatory Direction, these will continue to be legally effective after 1 July, 2014, unless you complete the new Advance Care Directive Form”.
In light of the medical advances made over the last few years it may be best to leave out any instructions and leave same to the Substitute Decision Maker who you have appointed (and hence trust) to make any such decisions for you.