End-of-life Care – Make Your Wishes Known

July 3, 2017

There is a common expectation that your wishes for medical treatment will be respected at the end of your life if an accident or progressive disease has taken your decision-making capacity. But there are many variables when it comes to what medical treatment can and should be provided.

Without clear instructions which cover these situations, your family may be left making many tough choices for you. That’s what Advance Health Directives are intended for – to give your family and your medical care providers a clear outline of what you want.

With a growing number of people expected to be affected by dementia and other cognitive degeneration over the next decade, it is worth considering Advance Health Directives, as they are known in Queensland (AHD), or Advance Care Directives as they are known in NSW, as a method of ensuring that your wishes are considered and your directions followed when critical treatment decisions need to be made.

While an enduring power of attorney authorises your attorneys to make decisions about your personal affairs, your finances and your general health, they do not provide detailed specifics about your healthcare and do not authorise your attorneys to make many of the important end-of-life care decisions.

An AHD is a written statement setting out in detail how you wish to be cared for when you are incapable of making health care decisions for yourself, with specific instructions about when certain types of life-sustaining medical treatment are to be withheld, such as:

1. blood transfusions;
2. artificial hydration and nutrition (food and water provided through a tube into your stomach, intestine or vein);
3. cardio-pulmonary resuscitation, to maintain your heartbeat; or
4. assisted ventilation, to support you to breathe if your lungs stop functioning.

You can also use AHDs to express general wishes about care and medical treatment, or directions about the quality of life you expect if you lose capacity.

In this way, an AHD can ease the burden on families making difficult decisions about a family member’s healthcare in a crisis situation, where a person’s wishes may not be as easily ascertained as they would be if the discussion had taken place earlier and were clearly set out in an AHD.

For this reason, hospitals and aged care facilities are increasingly requesting AHDs for their patients and residents.

For more information please contact Norman Fox, Michael Cowley or Melissa Hill.