What Is an Advance Care Directive, and How Do You Make One in Australia?

Detailed Explanation

An advance care directive answers a different question from a will or a set of funeral wishes. A will decides who gets your assets after you die. Funeral wishes describe the service you'd like. An advance care directive is about the period before death, if you're alive but unable to speak for yourself: what medical treatment you would and wouldn't want. See the End-of-Life Planning hub for how all of these documents fit together.

What it actually covers

A typical directive lets you record:

• Treatments you would refuse in defined circumstances: resuscitation (CPR), mechanical ventilation, artificial feeding or hydration, or specific procedures, usually tied to a stated condition ("if I have an irreversible terminal illness with no reasonable prospect of recovery").
• Treatments or approaches you'd want prioritised: comfort and pain relief over life-prolonging intervention, for example, or the reverse if that reflects your values.
• Personal and cultural values that should guide decisions doctors and family have to make on your behalf: religious beliefs, quality-of-life priorities, anything that helps someone else reason the way you would.

It only ever activates once a treating doctor has formally assessed that you lack the capacity to make or communicate the decision yourself. If you can still communicate your wishes, even partially, your own real-time decision overrides anything written down earlier.

How this differs across Australia

Every state and territory has its own legislation, its own official form, and often its own name for the document: "advance care directive" in some states, "advance health directive" in others. The bigger practical difference is structural: some states combine your own treatment wishes and the appointment of a substitute decision-maker into one document, while others keep "what I want" and "who decides for me" as two separate forms. None of this changes the underlying purpose, but it does change which specific form you need. Check your own state or territory health department's current advance care planning page, or Advance Care Planning Australia, rather than assuming a process described for one state applies in another.

How to actually make one

1. Get the correct form for your state. State health departments and Advance Care Planning Australia both publish free, current templates. There's no need to pay for a generic or interstate one.
2. Think it through before writing it down. The most useful directives come from an honest conversation with yourself (and often a GP) about what quality of life and what treatments matter to you, not just filling in boxes.
3. Appoint a substitute decision-maker if your state's form allows it: someone who knows you well and is willing to advocate for your wishes under pressure, in the room, in real time. This doesn't have to be family; see how do you plan ahead if you have no family or next of kin if there's no relative who can take this on.
4. Sign and witness it correctly. Requirements vary by state but commonly include one or two independent witnesses (not the decision-maker you're appointing), and some states require a doctor or authorised person to confirm you understood the document when you signed it.
5. Give copies to the people who'll need it. Your GP, your substitute decision-maker, and close family. A directive nobody knows exists, or that's locked in a drawer during a medical emergency, can't help anyone. Some states also offer a register where hospitals can look it up directly.
6. Review it periodically, and especially after a major diagnosis or a significant change in your health or values. A directive written at 50 may not reflect what you'd want at 80.

Things to Consider

• It works alongside your will, not instead of it. A will has no authority over medical treatment while you're alive; an advance care directive has no authority over your assets after you die. Most people benefit from having both, plus a record of funeral wishes for the third, separate moment that document covers.
• Doctors and hospitals are used to these. Presenting a valid directive on admission is a normal, expected part of hospital intake in a medical crisis. It isn't confronting or unusual to hand one over.
• A directive can't anticipate everything. Medicine changes, and no document covers every possible scenario. This is exactly why appointing a trusted substitute decision-maker, where your state's form allows it, matters as much as the written wishes themselves.
• Interstate moves matter. If you move to a different state, check whether your existing directive is recognised there or needs replacing with that state's own form. Most are recognised nationally in practice, but the safest approach is to confirm rather than assume.

Common Mistakes

• Confusing it with a will or funeral wishes. All three matter, but they answer different questions and none of them substitutes for the others.
• Writing it and telling no one. A perfectly valid directive that no one can find during a medical emergency provides no protection at all.
• Being too vague to actually guide a decision. "I don't want to suffer" is a value, not an instruction a doctor can act on. Naming specific treatments and circumstances gives your substitute decision-maker and medical team something concrete to follow.
• Assuming one state's form works everywhere. Using a template from the wrong state can mean it isn't legally recognised where you actually need it used.
• Never updating it. Values and health circumstances change; a directive from decades earlier may no longer reflect what you'd actually want.