Before a person suffers from any impaired decision-making capacity, legal documents can be prepared to set out their instructions, wishes and preferences for health, accommodation and personal matters.

What is an Advance Care Directive?

An Advanced Care Directive (ACD) enables adults to make arrangements for their future wishes and instructions about:

  • most types of health care
  • lawful treatment decisions in the terminal phases of illness
  • accommodation
  • personal matters.

An ACD can also be used to appoint one or more substitute decision-makers to make decisions on the person’s behalf when they are unable to do so.

An ACD does not relate to financial matters - this is the role of an Enduring Power of Attorney. SACAT does not make orders about EPA directives.

Applications to SACAT

SACAT does not provide initial advice, dispute resolution or give initial directions or declarations about issues arising under Advance Care Directives. These are functions performed by the Public Advocate.

SACAT will usually only review or make a declaration about an issue arising under an Advance Care Directive if the Public Advocate has previously tried to resolve the matter or mediate the issue.

If the Public Advocate has not first dealt with the matter SACAT can refer it back to the Public Advocate for mediation.

SACAT can:

  • cancel an Advance Care Directive when a person is no longer competent or has limited understanding (s32 Advance Care Directives Act)
  • review an Advance Care Directive to replace a substitute decision-maker who is ineligible, no longer willing to act, has been negligent or is in such default that they are not fit to be the substitute decision-maker in the exercise of their duties. (s 51 Advance Care Directives Act)
  • review an Advance Care Directive to replace a substitute decision-maker because of a change of circumstances. Only the Public Advocate can apply in this situation.
  • provide directions if advised of a person’s wish for cancellation of an ACD where a person is not competent or has limited understanding (s 31 Advance Care Directives Act)
  • review a matter dealt with by the Public Advocate to resolve disputes arising under an advance care directive (s 48(1)(a) Advance Care Directives Act)and
  • make declarations and directions about issues and disputes that might arise under an advance care directive (s 48(1)(b) Advance Care Directives Act.
  • revoke an Enduring Power of Attorney by making an administration order. (Applications about disputes or other issues arising under an Enduring Power of Attorney are made to the Supreme Court under the Powers of Attorney and Agency Act 1984. However, SACAT can make an administration order if the arrangements under an EPA are not working or if an appointed attorney no longer wishes to act. The appointed administrator can then revoke the EPA).

Older documents

Previously there were three other documents that covered some of these matters (these three documents listed below are still valid if made before 1 July 2014 and will be treated as if they were made under the Advance Care Directives Act 2013). 

An Advance Care Directive now replaces:

  • Enduring Power of Guardianship
  • Medical Power of Attorney
  • Anticipatory Direction.