When a person comes to the end of their life, and are unable to make choices for themselves about their care, it can often come down to their loved ones and the healthcare professionals around them.
And unless you know what they want, it can be hard to know exactly what to do.
Last week, new laws were passed in Victoria which legalises advance care directives under the “The Medical Treatment Planning and Decisions Act”.
Under the Act Victorians can create a legally binding advance care directive that will allow them to:
- Specify treatment they consent to, or refuse in an instructional directive.
- Describe their views and values relating to future treatment in what is called a “values directive”. People who are nominated to make medical treatment decisions and health practitioners will be required to give effect to a values directive.
- Appoint a medical treatment decision maker to make decisions on their behalf when they no longer have decision making capacity.
- Appoint a support person to help them make decisions, by collecting and interpreting information or assisting them to communicate their decisions.
How Can You Make an Advance Care Directive?
Advance care directives can only be made by people who have decision-making capacity and must be witnessed by two adults, including one medical practitioner.
The doctor’s role is to ensure the person understands the nature and effect of their statements in the advance care directive, and their possible implications.
The witnesses must certify that the person appeared to have decision-making capacity in relation to each statement in their directive, freely and voluntarily signed the document and appeared to understand the nature and effect of each statement in their directive.
The Act defines palliative care as ‘reasonable medical treatment for the relief of pain, suffering and discomfort, and the reasonable provision of food and water.’
A person cannot refuse palliative care as part of an instructional directive but can include statements about palliative care in their values directive.
For example, a person may state in their values directive that at the end of their life it is more important for them to remain lucid than completely pain-free.
Creating a Values Directive
To effectively communicate your values and preferences to others, you must first know and understand these yourself.
According to Advance Care Planning Australia, if you are interested in making a proper advance care plan, there are a number of things to consider; to make the process easier for you and your substitute decision maker;
Consider your beliefs, values and preferences for your current and future health. Think about the medical treatment you may or may not want. This is no different to arranging your life insurance or your will. There are no wrong answers to these questions.
- Do you feel you have a good understanding of your current health?
- What makes life worth living?
- What abilities do you need to maintain to preserve your dignity? Feeding yourself? toileting independently?
- How would you feel if you cannot recognise or understand your family? What if you are not able to talk to them?
- What if you lost your independence and needed help to do everything?
- What treatments will help you to live the way you want?
- How may your beliefs about religion and spirituality affect your choice of medical treatments?
- Are there any medical treatments that you feel strongly about, either having or not having?
Consider your beliefs, values and preferences for your current and future health. Think about the medical treatment you may or may not want. This is no different to arranging your life insurance or your Will. There are no wrong answers to these questions.
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