Resolving ‘consent to medical treatment’ disputes / Review of Public Advocate determinations

SACAT can:


•    resolve disputes arising about a ‘consent to medical treatment decision’ 
•    give a declaration or direction about an issue arising about a ‘consent to medical treatment decision’ 
•    review a consent to treatment matter dealt with by the Public Advocate at mediation.

SACAT does not:


•    resolve disputes about the treatment of a person for mental illness under the Mental Health Act or about prescribed medical treatment or about a certain type of prescribed psychiatric treatment (being neurosurgery) in the case of mental illness 
•    give a declaration or direction about an issue arising about the treatment of a person for mental illness under the Mental Health Act or about prescribed medical treatment or about a certain type of prescribed psychiatric treatment (being neurosurgery) in the case of mental illness. 

What sort of issues or disputes can arise about a ‘consent to medical treatment’ decision? 

These issues or disputes can include the following:

•    the nature or extent of the responsibilities of the person responsible for the patient
•    how to interpret the wording of an advance care directive, if there is one,  to give effect to the wishes of the person who has prepared it 
•    whether the person who requires the medical treatment has impaired decision making capacity about a particular decision
•    the potential advantages or disadvantages of the proposed or requested medical treatment
•    whether the proposed treatment is in the best interests of the relevant person’s health and well being
•    whether, and in what circumstances, a person responsible can refuse to give consent to health care/medical treatment or life sustaining treatment.

Where there are disputes you should first seek the assistance of the Public Advocate to mediate the matter

An application to SACAT to resolve a dispute by way of declaration or direction can be made if required.
 
When to apply to SACAT for a declaration or direction or for a review of decision by the Public Advocate

You can also apply directly to SACAT for a declaration or direction about a ‘consent to medical treatment decision’ (except for those detailed above that SACAT does deal with in this way.)

However, SACAT may refer the matter back to the Public Advocate for mediation if it has not first been referred to the Public Advocate and SACAT considers the Public Advocate can more appropriately deal with the issue

If the Public Advocate has resolved a matter by mediation you can apply to SACAT for a review of the Public Advocate’s mediation decision.

Who can apply? 

The following persons can apply to SACAT for the review of a matter mediated by the Public Advocate or to seek a declaration or direction about a treatment decision:
•    a parent or guardian of a child
•    a “person responsible” for a person with impaired decision making capacity as set out in s 14 of the Consent to Medical Treatment and Palliative Care Act.
•    a medical practitioner providing or wishing to provide the relevant medical treatment 
•    any person who satisfies SACAT that they have a proper interest in the particular matter 

Right to Review of a SACAT decision (Internal Review)

There is a right to Review of a SACAT decision to make a declaration or direction in relation to a ‘consent to medical treatment’ decision. You do not need to seek permission for this Review.

Who can apply for Review of a SACAT decision (Internal Review)?

An application for Internal Review can be made by:
•    the applicant for the declaration or directions regarding consent to medical treatment
•    the person who the application is about
•    the Public Advocate
•    any person who presented evidence or material or made submissions to SACAT about the matter
•    any other person who satisfies SACAT that he or she has a proper interest in the matter.