Advance care planning FAQs

What is advance care planning?

Advance care planning is a voluntary process of planning for future health and personal care whereby your values, beliefs and preferences are made known to guide decision-making at a future time when you cannot make or communicate your decisions.

What is the difference between advance care planning, a Values and Preferences Form, a Values and Preferences Statement and an Advance Health Directive?

Advance care planning is the voluntary process of planning for future health and personal care whereby your values, beliefs and preferences are made known, to guide decision-making at a future time when you cannot make or communicate your decisions.

As a part of this process, you may choose to complete an advance care planning document to record your values, beliefs, preferences and treatment decisions. In WA, advance care planning documents include the following:

• A Values and Preferences Form: Planning for my future care (PDF 486KB), is a document in which you can record what you value and what you want for your care in the future including where you want to live, and other things that are important to you. This form may be considered a Common Law Directive (for more information, see FAQ What is the difference between a Common Law Directive and an Advance Health Directive?).
• An Values and preferences statement for a person with impaired decision-making capacity (external site) is a document written on your behalf by a recognised decision-maker(s) who has a close and continuing relationship with you (i.e. the person highest on the hierarchy of treatment decision-makers who is available and willing to make decisions). This document can be used to guide decision-makers and health professionals when making medical treatment decisions on your behalf, if you do not have a valid Advance Health Directive or Values and Preferences Form. It should only be made when a person no longer has decision-making capacity to complete a Values and Preferences Form or an Advance Health Directive. This document is a non-statutory document and is not a document in which a person is able to give legal consent to or refuse treatment.
• An Advance Health Directive (PDF 500KB) is a legal record of your decisions about treatment(s) you do or do not want to receive if you become unwell or injured in future. It can only be made by a person older than 18 years who is able to make and communicate their own decisions. The Advance Health Directive is a statutory document as it is recognised under legislation. Statutory documents are the strongest and most formal way to record your wishes.

Who needs to do advance care planning?

Everyone should consider advance care planning, regardless of their age or health. It can be particularly important to individuals such as people with an advanced chronic illness, a life-limiting illness, are aged 75+ years or at risk of losing competence.

When should my advance care planning discussion be reviewed?

• When you and/ or your carer/ family requests or changes your/ their mind about any previous decisions.
• Where your medical condition or individual circumstances change (e.g. diagnosis of new illness, death of a carer/partner, change in location of care etc).
• When returning to hospital for any treatment.
• If treatment options or medical care available for you changes your needs in regards to advance care planning (for example, a new treatment for a disease, diagnosis of a co-morbidity etc).

Why is the revised Advance Health Directive longer than the previous version?

The revised Advance Health Directive (AHD) is longer than the previous version as improvements were needed to reflect the important findings of the Ministerial Expert Panel on Advance Health Directives (MEP) and the needs of the community.

The MEP spoke to a wide range of people on AHDs to see if AHDs met the needs of the community and clinicians who use them and what changes were required.

The Department of Health used this information to develop the new AHD in 2022 with further input from key contributors such as clinicians, community members, legal advice and the Department of Justice. This longer version reflects the recommendations made by the MEP and what we learnt from our discussions.

The new Advance Health Directive form is longer – is it harder to complete?

Although it has more pages, the changes made to the new AHD have helped make the document easier to complete and understand. The new AHD now includes:

• more guidance and examples to help you to complete each question and be as specific as possible with each response
• both tick box and free text questions to allow you to record your treatment decisions in a variety of ways and include as much detail as possible to inform those who may make decisions on your behalf in the future
• a section on consent to medical research
• a section to capture your values and preferences.
  • It can be hard to think of all the specific treatments you may need in the future. By recording your values and preferences you are giving those close to you and your health professionals a better understanding of what types of things are important to you. This will help inform decisions they may need to make on your behalf if you require a treatment in the future that you were unable to specify in the treatment decisions part of the AHD.

Things to remember:

• Each page provides large blank spaces to allow you to record your responses which also adds to the length of the form.
• There are some sections which you can cross out if you do not wish to complete them – these are clearly marked on the AHD. 

Why has a medical research section been added to the revised AHD?

In 2020 Guardianship and Administration Act 1990 was amended to provide pathways for the participation of adults who do not have the capacity to consent in health and medical research under Part 9E of the Act. A person’s involvement in medical research, and any treatments received as part of the medical research, must be consistent with decisions they have made in an AHD. The revised AHD includes the research activities and circumstances in which someone does or does not consent to as listed in the Act.

Can I use a modified version or my own template for an Advance Health Directive?

If you are making a new Advance Health Directive you should use the current form (PDF 500KB) prescribed under the Guardianship and Administration Act 1990.  A modified version or different template may not be considered a valid Advance Health Directive in accordance with the legal requirements of the Guardianship and Administration Act 1990.

The current form was developed through a rigorous consultation process to reflect the findings of the Ministerial Expert Panel on Advance Health Directives and the needs of the community. By using the current form, it is less likely that the validity of your AHD would be queried or challenged. Also, the Department of Health is educating health professionals on the updated form so this is the format that health professionals will be most familiar with.

If you are in doubt about the validity of your Advance Health Directive you are encouraged to seek legal advice when completing it. 

Please note that the Department of Health only provides general advice regarding Advance Health Directives, not legal advice.  

Can an Advance Health Directive include permission regarding organ donation?

No, an AHD cannot be used to formally register your interest in organ and tissue donation. Organ and tissue donation should be formally registered at donatelife (external site). It is also important you talk to family, as relatives will be asked to agree.

Does an Advance Health Directive permit euthanasia?

No. An AHD cannot be used to access voluntary assisted dying. They operate independently of each other.

Who needs to witness my signature on my Advance Health Directive?

You must sign this Advance Health Directive in the presence of 2 witnesses. If you are physically incapable of signing this Advance Health Directive, you can ask another person to sign for you. You must be present when the person signs for you.

Each of the witnesses must be 18 years of age or older and cannot be you or the person signing for you (if applicable).

At least one of the witnesses must be authorised by law to take statutory declarations. Schedule 2 of the Oaths, Affidavits and Statutory Declarations Act 2005 (external site) has the full list of people who can witness a statutory declaration. All registered health professionals and lawyers are included on this list.

The witnesses must also sign this Advance Health Directive. Both witnesses must be present when each of them signs. You and the person signing for you (if applicable) must also be present when the witnesses sign.

Can I be forced to sign an Advance Health Directive against my will?

No. All treatment decisions made in an Advance Health Directive must be made voluntarily. A treatment decision that was forced/made against your will under inducement or coercion is not valid. If a family member or health professional suspects that an Advance Health Directive was not made voluntarily or was influenced by inducement or coercion, an application should be made to the State Administrative Tribunal under the Guardianship and Administration Act 1990 for a determination of (in)validity.

Can I ask my doctor to witness my Advance Health Directive?

Yes. You can ask your doctor to witness your Advance Health Directive. Your doctor must sign as a witness, in the presence of another witness (who also needs to be over 18 years of age).

Can I ask a family member to witness my Advance Health Directive?

Yes. However, it is recommended that independent witnesses are chosen rather than family members.

Can I ask my interpreter/translator to witness my Advance Health Directive?

No. If you used the services of a interpreter/translator when preparing your Advance Health Directive, your interpreter/translator cannot witness your signature on the Advance Health Directive.

I am not able to sign my Advance Health Directive – can someone else sign on my behalf?

If you are unable to sign your completed Advance Health Directive, you can ask someone else to sign it on your behalf. The person who signs on your behalf will have to complete the second option on the signing page in Part 6 of the Advance Health Directive.

If you wish to ‘sign’ the Advance Health Directive yourself by making a mark of any kind, other than a signature, you must complete the marksman clause (PDF 291KB) and attach it to Part 6 of your Advance Health Directive. The same witnessing requirements apply even if you use a marksman clause. If you include a marksman clause, it is recommended that you seek legal advice from a solicitor or community legal service.

Can I include additional pages to my Advance Health Directive?

Yes. You can add more information to your Advance Health Directive as long as you do this before it is signed and witnessed. You cannot add additional pages once your Advance Health Directive is witnessed and signed.

How do I add pages to my Advance Health Directive?

To add pages to your Advance Health Directive, make sure you:

• use a format that is consistent with the relevant section of the Advance Health Directive to which you are adding pages:
  • if you are adding pages to Part 4.1, you can use the additional pages for Part 4.1 – Other life-sustaining treatment decisions (PDF 66KB)
  • if you are adding pages to Part 4.2, you can use the additional pages for Part 4.2 – Other treatment decisions (PDF 82KB)
  • if you are adding a interpreter/translator statement, use the interpreter/translator statement (PDF 74KB) and attach it to Part 5.1
  • if you are adding a marksman clause, use the marksman clause (PDF 70KB) and attach it to Part 6
• physically attach (e.g. staple) the additional pages to the relevant section of the Advance Health Directive
• sign and date the bottom of the additional pages when you sign the Advance Health Directive (Part 6) in front of your witnesses
• make sure your witnesses sign the bottom of any additional pages attached to the Advance Health Directive at the same time as they sign Part 6.

You can download the additional pages, statements and clauses or order hard copies from the Department of Health Advance Care Planning Information Line (via the online order form (external site), on phone 9222 2300 or email: ACP@health.wa.gov.au).

Can I make additions and/or changes to the decisions in my Advance Health Directive once it has been signed and witnessed?

No. You cannot add to and/or change the decisions in your Advance Health Directive after it has been signed and witnessed. If you need to change your Advance Health Directive, you should revoke (or cancel) your current Advance Health Directive and make a new one.

What happens if I change my address or contact details after my Advance Health Directive has been signed and witnessed?

Your Advance Health Directive remains valid if you change your address and/or contact details. You do not need to revoke (cancel) your Advance Health Directive if only your personal details change. You can simply let the people who have a copy of your Advance Health Directive know your updated personal details.

How do I revoke (or cancel) my Advance Health Directive?

To revoke an Advance Health Directive, you must have full legal capacity. The law provides safeguards to ensure that Advance Health Directives cannot be made, amended or revoked if a person does not have capacity. There is a statement in the Advance Health Directive that allows you to indicate that you are revoking a previous version.

The WA Department of Health recommends that you write to everyone relevant (people and organisations) to tell them you have revoked (cancelled) your Advance Health Directive. This may include your GP, other health professionals, healthcare providers, family members and/or friends who currently hold a copy of your Advance Health Directive. Everyone who has an old copy of your Advance Health Directive should return it to you, and you should destroy the old copies.

What is a translator or interpreter?

Translators deal with the written word. They translate written documents from one language to another.

Interpreters deal with the spoken word or signed languages (such as Auslan). They interpret what each speaker is saying or signing into the other person’s language.

Is the Advance Health Directive available in a language other than English?

No. The Advance Health Directive is only available in English and your responses must be written in English to be valid. This guide and other advance care planning information is available in multiple languages. Learn more about Advance Health Directives.

Can I access an interpreter or translator to help me with my Advance Health Directive?

Yes. You can use the services of an interpreter and/or translator when making the Advance Health Directive. It is recommended that your interpreter/translator be qualified and/or credentialed in interpreting or translating. You and your interpreter/translator should complete the interpreter/translator statement (PDF 433KB) and attach it to Part 5.1 of your Advance Health Directive.

Can I request my doctor engages an interpreter so we can discuss my Advance Health Directive?

Yes. If you would like to discuss your Advance Health Directive with your doctor (or any other health professional involved in your care) you can request the use of an interpreter service. The interpreter may be in the room with you or they may interpret your discussion over the phone or using videoconference.

What should my interpreter/translator and I do to complete the Advance Health Directive?

You and your interpreter/translator should complete the interpreter/translator statement (PDF 313KB) and attach this to Part 5.1 of your completed Advance Health Directive.

How do I make an Advance Health Directive if I am vision impaired, or if I am unable to read and/or write?

Being unable to read and/or write, and/or sign your name does not prevent you from making an Advance Health Directive. You can ask someone to read the Advance Health Directive (and the Guide to Making an Advance Health Directive in Western Australia) to you, and you can ask for help to complete the Advance Health Directive. If you are unable to sign your completed Advance Health Directive, you can ask someone else to sign it on your behalf. The person who signs on your behalf will have to complete the second option on the signing page in Part 6.

If you wish to ‘sign’ the Advance Health Directive yourself by making a mark of any kind, other than a signature, you must complete the marksman clause (PDF 286KB) and attach it to Part 6 of your Advance Health Directive. The same witnessing requirements apply even if you use a marksman clause. If you include a marksman clause, it is recommended that you seek legal advice from a solicitor or community legal service.

How do I make a certified copy of my Advance Health Directive?

A certified copy is a photocopy of a document that has been certified as a direct copy of the original document by an authorised witness. There is no legislation in WA that states either how to certify a copy of a document and/or who can do it.

However, it is usual for documents to be certified by a person who is authorised as a witness for statutory declarations under Schedule 2 of the Oaths, Affidavits and Statutory Declarations Act 2005 (external site). For more information on certifying copies of your Advance Health Directive, see the website of the Office of the Public Advocate (external site) or Department of Justice Information Fact Sheet – Certifying Copies of Documents (external site).

Do I need to tell people that I have made an Advance Health Directive?

It is highly recommended that you tell people close to you, and people involved in your care, that you have made an Advance Health Directive and share a copy with them. Tell them where you have stored your Advance Health Directive, so they can easily access it if needed in future.

It is particularly important to let your health professionals know you have and Advance Health Directive and share a copy. Health professionals cannot honour something that they do not know exists. It is your responsibility to make sure that everyone who may be involved in your care is aware that you have written an Advance Health Directive, or appointed an Enduring Guardian, or both.

What should I do with my completed Advance Health Directive?

You should keep your original Advance Health Directive in a safe place. You can store a copy of your Advance Health Directive online using My Health Record. To upload your Advance Health Directive to My Health Record go to digitalhealth.gov.au (external site). It is recommended that you tell people close to you and those who are involved in your care that you have made an Advance Health Directive. You can share a copy of your completed Advance Health Directive with as many people that are close to you as you would like. This may include:

• your family, friends and carers
• enduring guardian(s)
• GP/local doctor
• other specialist(s) and/or other
• health professionals
• residential aged care home
• local hospital where you may receive emergency, outpatient and/or inpatient care
• legal professionals.

You can also use the following, to let people know that you have an Advance Health Directive:

• carry an Advance Health Directive alert card in your purse or wallet – you can order an alert card by contacting the Department of Health Advance Care Planning Line via the online order form (external site), on phone 9222 2300 or email: ACP@health.wa.gov.au.
• wear a MedicAlert (external site) bracelet.

You are encouraged to write a list of all the people who have a current copy of your advance care planning documents should you wish to revoke or update those documents in the future. Having this list will make it easier for you to remember who you should give any updated advance care planning documents to.

Do I have to register my Advance Health Directive?

No. You are not legally required to register your Advance Health Directive. It is recommended that you tell people close to you and those who are involved in your care that you have made an Advance Health Directive and share a copy with them. 

It is also recommended that you upload a copy to My Health Record. To upload your Advance Health Directive to My Health Record go to digitalhealth.gov.au (external site).

Tip – You may need to scan your Advance Health Directive in black and white and at 300dpi to reduce the PDF file size. Documents larger than 20MB cannot be uploaded to My Health Record.

How can I reduce the file size of my scanned Advance Health Directive?

To reduce the file size of your scanned Advance Health Directive, check your scanner settings for the following:

• scan in black and white
• choose the recommended dpi setting for text-based documents e.g. 300 dpi.

These settings will provide the legibility you need and produce a reasonably sized document.

Documents larger than 20MB cannot be uploaded to My Health Record. Your health professionals may also have problems uploading a copy of your Advance Health Directive to their electronic patient record systems if the file size is too large. Keeping the file size to a minimum will make sure your Advance Health Directive is accessible when needed.

The Australian Digital Health Agency provides more information on uploading advance care planning documents to My Health Record (external site).

What is an Enduring Power of Guardianship?

An Enduring Power of Guardianship (EPG) is a legal document that authorises a person of your choice, to make important personal, lifestyle and treatment decisions on your behalf should you ever become incapable of making or communicating decisions yourself.

This person(s) is known as an enduring guardian. You can authorise an enduring guardian to make decisions about where you live, the support services you have access to, and the treatment you receive. You cannot authorise an enduring guardian to make decisions about your property or financial matters. You can have more than one enduring guardian but they must act jointly which means they must reach agreement on any decisions they make on the person’s behalf.

For more information on Enduring Power of Guardianship and enduring guardians, see the website of the Office of the Public Advocate (external site).

Can I appoint an enduring guardian?

If you are 18 and over, and have the capacity to form your own decisions, you can make an EPG.

When will my enduring guardian have the power to make decisions for me?

Your EPG will only be used if and when you become unable to make decisions for yourself.

You choose the decisions your enduring guardian will be able to make, such as where you live and what treatment you receive.

If you have made an Advance Health Directive, it will take priority over the decisions of your enduring guardian for the treatment stated in the document, as per the hierarchy of treatment decision-makers (PDF 1.5MB).

What is the difference between Enduring Power of Guardianship and an Advanced Health Directive?

An Enduring Power of Guardianship (EPG) is a legal document where you can appoint one or more persons as an enduring guardian to make personal, lifestyle and treatment decisions for you.

You can choose the type of decisions your enduring guardian will be able to make. These decisions can include where you will live, and what treatment you will receive.

An Advance Health Directive (AHD) is a legal document that enables a person to make decisions now about the treatment they would want – or not want – to receive if they ever became sick or injured and were incapable of communicating their wishes. In such circumstances, their AHD would effectively become their voice.

You can have both an AHD and EPG, but your AHD will override your EPG when it comes to treatment. This means that if you are unable to make a treatment decision yourself, the instructions in your AHD will be used instead of asking your enduring guardian to make these decisions on your behalf, unless the AHD is invalid or does not cover the required treatment.

If I make an Advance Health Directive, do I need to make an Enduring Power of Guardianship too?

No. You are under no obligation to make an Enduring Power of Guardianship just because you have made an Advance Health Directive. However, by appointing an enduring guardian, you will increase the likelihood that decisions made on your behalf will reflect your values, beliefs and preferences if you become unable to make or communicate these decisions yourself.

What is the difference between an enduring guardian and an enduring attorney?

An Enduring Attorney is not able to make personal, lifestyle and treatment decisions on your behalf. The authority of the enduring attorney is limited to making decisions about financial affairs and property.

It is possible to appoint the same person as both your enduring guardian and enduring attorney. This often happens when one family member has more ability or time to undertake the role.

Can I appoint an enduring guardian in my Advance Health Directive?

No, you cannot appoint an enduring guardian in your Advance Health Directive. To appoint an enduring guardian, you must complete an Enduring Power of Guardianship form which is available from Office of the Public Advocate (external site).

Can my enduring guardian make an Advance Health Directive on my behalf?

It is not possible for another person to make an Advance Health Directive on your behalf.  You need to create an Advance Health Directive or appoint an Enduring Power of Guardianship whilst you have capacity.

Additional FAQs on Enduring Power of Guardianship can be found on the  Office of the Public Advocate Enduring Power of Guardianship frequently asked questions (external site).