Most Australians have heard of a will. Many have heard of a power of attorney. But the advance care directive — or healthcare directive — is the document that is most often missing from an estate plan, and arguably the one that matters most in the moments leading up to death.
If you were unconscious in hospital tomorrow, who would speak for you? Would they know what you'd want?
What Is a Healthcare Directive?
A healthcare directive is a legal document that records your wishes about medical treatment in advance — so that if you ever can't communicate those wishes yourself, your doctors and family know exactly what you want.
It can also appoint someone you trust to make medical decisions on your behalf. Depending on your state or territory, this document might be called:
- Advance Care Directive (SA, QLD, NT, ACT)
- Advance Care Plan (general term used across Australia)
- Enduring Guardian (NSW, WA, TAS) — appoints a person to make personal and health decisions
- Medical Treatment Decision Maker (VIC)
The terminology varies but the purpose is the same: to give you a voice when you no longer have one.
What Can It Cover?
A healthcare directive can address:
- Whether you want life-sustaining treatment in specific circumstances (e.g. if you are in a permanent vegetative state)
- Your wishes around pain management and palliative care
- Whether you want resuscitation attempted
- Religious or personal values that should guide decision-making
- Specific treatments you do or don't want
- Where you want to be cared for (home, hospice, hospital)
- Who you want to make decisions if you can't
Why Does It Matter?
Without a healthcare directive, medical decisions fall to your next of kin — in a hierarchy determined by law, not by you. That might be a spouse, an adult child, or a parent.
They may not know what you want. They may disagree with each other. And they will be making these decisions under enormous emotional pressure, often at the worst moment of their lives.
A healthcare directive removes that burden. It gives your family certainty and protects them from guilt — because they're following your instructions, not making judgment calls about your life.
Is It the Same as a "Do Not Resuscitate" Order?
No. A "Do Not Resuscitate" (DNR) order is a specific medical instruction issued by a doctor. A healthcare directive is a broader legal document that records your overall wishes — which may include preferences around resuscitation, but covers much more ground.
Your directive informs your treating doctors and can be the basis for a DNR order if that is your wish.
How Is It Different From an Enduring Power of Attorney?
An enduring power of attorney covers financial and legal decisions. A healthcare directive covers medical and personal decisions. They are separate documents that work together.
Think of it this way: the EPA ensures someone can pay your bills and manage your property. The healthcare directive ensures someone can speak for your body and your care.
You need both.
State-by-State Requirements
Requirements for a valid healthcare directive vary significantly across Australia:
- NSW: Appointment of Enduring Guardian — must be witnessed by a solicitor or barrister, or two adult witnesses (neither a guardian nor a relative)
- VIC: Supportive Attorney / Medical Treatment Decision Maker — specific forms required
- QLD: Advance Health Directive — must be completed with a doctor present
- SA: Advance Care Directive — replaces several older documents
- WA: Enduring Power of Guardianship + Advance Health Directive
- TAS: Enduring Guardianship
- ACT: Health Attorney / Advance Care Plan
- NT: Advance Personal Plan
Getting this right matters. An improperly executed document may not be legally binding when it's needed most. Our estate planning team can prepare the correct documents for your state or territory.
Who Should Have One?
Everyone over 18. But especially:
- People with chronic illness or a terminal diagnosis
- Anyone having surgery or a medical procedure
- Older Australians planning for their future care
- Anyone who has strong views about end-of-life care
- People whose family members might disagree about their care
And if you're a parent, consider preparing one even in your 30s and 40s. Accidents don't discriminate by age.
Store It Where It Can Be Found
A healthcare directive stored in a filing cabinet at home — or left with a solicitor who can't be reached at 2am — is of limited use in an emergency.
Custodium Vault lets you store your healthcare directive securely alongside your other important documents, with immediate access for the people you've designated. Your medical advocate can access it from a phone, at any hour, anywhere — exactly when they need it.
See our plans and protect your family with everything in one place.
The Bottom Line
A healthcare directive is not a morbid document. It is an act of love — one that spares your family from impossible decisions and ensures your wishes are respected even when you can no longer express them.
If you don't have one, our estate planning team can prepare the right document for your state and your situation. Request a confidential consultation to get started.