Healthy living

Advance care planning FAQs

The frequently asked questions are broken into topics to to help you learn more about advance care planning. 
Advance care planning process

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, an Advance Care Plan 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 Advance care plan for someone with insufficient 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 used 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. Non-statutory documents are not recognised under specific legislation.
  •  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).
Advance Health Directives – General

What is an Advance Health Directive?

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

Why is it helpful to make an Advance Health Directive?

Completing an Advance Health Directive is helpful as it will allow health professionals to know what treatment you would want  or not want receive if you ever became sick or injured and were incapable of communicating your wishes.

It will also help to reassure you and your loved ones that they have a clear idea of what is desired by you in the event of illness or injury.

How do I make an Advance Health Directive?

The Guide to Making an Advance Health Directive in WA (PDF 500KB) provides detailed instructions on how to complete an Advance Health Directive including how to make sure it is signed and witnessed. You can access the Advance Health Directive online or order a hard copy from the Department of Health Advance Care Planning Information Line on phone 9222 2300  or email: ACP@health.wa.gov.au.

What if I do not make an Advance Health Directive?

If you do not make an Advance Health Directive, a health professional must go to the first person listed on the hierarchy, who is 18 years or older, has full legal capacity, and is available and willing to make the treatment decision.

If the first person is not available and willing to make the decision, the health professional can go to the next person in the hierarchy, and so on.

When will my Advance Health Directive be used?

Your Advance Health Directive will only be used at times when you are unable to make and/or communicate decisions about your treatment and health care and if it applies to the treatment that you require.

How long is my Advance Health Directive valid?

Decisions you make in your Advance Health Directive are valid:

  • until you die or
  • until you revoke (cancel) your Advance Health Directive or
  • while the treatment options listed in your Advance Health Directive remain relevant. Your Advance Health Directive will not apply to new treatment options that may become available after you complete the Advance Health Directive.

If I used an old template for my Advance Health Directive is it still valid?

Yes. If you made an Advance Health Directive using an old version of the form prior to 4 February 2023 and you followed all legal requirements to complete the form, it will continue to be valid.

Will my health professional always need to follow my decisions in my Advance Health Directive?

Yes. In most situations, if you become unable to make or communicate decisions about your treatment and care, health professionals must follow the decisions in your Advance Health Directive, except in some limited exceptions. A limited exception may occur if:

  • circumstances relevant to your treatment decision have changed since you made the treatment decision, and
  • you could not have reasonably anticipated those changes when you made your Advance
  • Health Directive, and
  • it is likely that a reasonable person with knowledge of the change of circumstances would change their mind about the treatment decision.

How often and when should I review my Advance Health Directive?

It is recommended you review your Advance Health Directive every 2 to 5 years, or if your circumstances change. For example, if you are diagnosed with a new ongoing and/or life-limiting illness you may need to review your Advance Health Directive earlier than 2 to 5 years. You will need to revoke any previous Advance Health Directives to make a new one.

To revoke an AHD, you must have full legal capacity. The law provides safeguards to ensure that AHDs cannot be made, amended or revoked if a person does not have capacity. Legislation does not spell out the process of revoking an AHD, the process is governed by common law. Written revocation of the AHD is not a legal requirement. There is a statement within the AHD template that allows you to indicate you are revoking any previous versions.

The Department recommends that you give written notification of the revocation to all relevant persons and organisations, including GPs, healthcare providers and family members and those who currently hold a copy of the AHD being revoked. All those who hold a copy should return it to you to be destroyed.

What is the difference between a Common Law Directive and an Advance Health Directive?

Common Law Directives are written or verbal communications which convey a person’s wishes regarding future health and personal care to be provided or withheld in specific future circumstances. There are no formal requirements in relation to Common Law Directives. There can be significant difficulties in establishing that a particular Common Law Directive is valid at law and can be followed. For this reason they are not recommended for making treatment decisions.

An Advance Health Directive 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.

What if nobody can access my Advance Health Directive in an emergency situation?

Treatment is regarded as urgent or an emergency if it is needed to save a person's life or prevent the person from suffering significant pain or distress.

Where a person requires urgent treatment and it is not practicable for the health professional to determine whether an Advance Health Directive has been made or to obtain a treatment decision from anybody in the hierarchy of treatment decision-makers (PDF 1.5MB), the health professional may provide the necessary treatment.

In cases where a person is in need of urgent treatment that the health professional believes is the result of attempted suicide, the health professional may administer the necessary treatment even:

  • if the person has made an Advance Health Directive in which consent for the required treatment is withheld
  • the person's guardian, enduring guardian or person with authority to make a decision withholds consent.
Advance Health Directives – what can and cannot be included

What is a life-sustaining treatment?

Life-sustaining treatment is health care that aims to keep a person alive and/or stay alive if they are at risk of dying. Examples of life-sustaining treatment include:

  • CPR (cardiopulmonary resuscitation) (e.g. treatment to keep your heart pumping when it has stopped beating)
  • assisted ventilation (e.g. a machine that helps with breathing through a face mask or a breathing tube)
  • artificial hydration (e.g. fluids given via a tube into a vein, tissues or the stomach)
  • artificial nutrition (e.g. a feeding tube through the nose or stomach)
  • receiving blood products (e.g. a blood transfusion)
  • antibiotics (e.g. drugs given to help fight infection, given by mouth injection or by drip tube).

Can an Advance Health Directive include permission for organ and tissue donation?

No. An Advance Health Directive cannot be used to formally register your interest in organ and tissue donation. Organ and tissue donation should be formally registered at donatelife.gov.au. It is also important to talk to family members about your decisions about organ and tissue donation, as relatives will be asked to agree to this if you die.

Can I consent to voluntary assisted dying in my Advance Health Directive?

No. Voluntary assisted dying is a legal option for Western Australians who meet the required eligibility criteria. It is not possible to include voluntary assisted dying in an Advance Health Directive, but if it is something you might consider as an option, you can speak with your healthcare provider or contact the WA VAD Statewide Care Navigator Service. The care navigators who staff the service are qualified health professionals with a wealth of knowledge regarding voluntary assisted dying as an end-of-life choice. They have extensive experience supporting patients, families and health professionals.

Advance Health Directives – witnessing, signatures

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 translator to witness my Advance Health Directive?

No. If you used the services of a translator when preparing your Advance Health Directive, your 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) provided with the Guide to Making an Advance Health Directive in Western Australia 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.

Advance Health Directives – additions, changes and revoking (cancelling)

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 4.2, you can use the additional pages for Part 4.2 – Other treatment decisions provided within the Guide to Making an Advance Health Directive in Western Australia
    • if you are adding a translator statement, use the translator statement provided within the Guide to Making an Advance Health Directive in Western Australia and attach it to Part 5.1
    • if you are adding a marksman clause, use the marksman clause provided within the Guide to Making an Advance Health Directive in Western Australia 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.

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.

Advance Health Directives – accessibility

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 a translator to help me with my Advance Health Directive?

Yes you can use the services of a translator when making the Advance Health Directive. It is recommended that your translator be qualified and/or credentialed in translating.

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.

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

You and your translator should complete the translator statement (PDF 313KB) provided with the Guide to Making an Advance Health Directive in Western Australia 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) provided with the Guide to Making an Advance Health Directive in Western Australia 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.

Advance Health Directives – Certified copies, sharing and storing

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. 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
  • 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 on 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.

Enduring Power of Guardianship

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).

Where to get help

Advance care planning

  • Department of Health WA Advance Care Planning Information Line
    General enquiries and to order advance care planning resources  (e.g. Advance Health Directives, Values and Preferences form)
    Phone: 9222 2300
    Email: ACP@health.wa.gov.au
  • Palliative Care Helpline
    Information and support on issues to do with advance care planning, palliative care, grief and loss
    Phone: 1800 573 299 (9:00 am to 5:00 pm every day)
    Palliative Care WA (external site)
  • Advance Care Planning Australia Free Support Service
    General queries and support with completing advance care planning documents
    Phone: 1300 208 582 (Monday to Friday 9:00 am – 5:00 pm AEST)
    Online referral form (external site)

Enduring Powers of Guardianship and Enduring Powers of Attorney

Last reviewed: 01-08-2022
Palliative Care WA helpline: 1800 573 299. White text on purple background. with two women talking on a bench in bottom right corner