New South Wales Advance Care Directives
In New South Wales, an advance care directive can be spoken or written, and a valid directive must be followed when it applies.
In New South Wales, an advance care directive records what health care and treatment you would want if you became seriously ill or injured and could not speak for yourself. A directive can be spoken or written, but a signed written document is easier for health professionals and family to use.
General information: This page gives general information for people in New South Wales. It is not legal advice. If the decision is urgent, complex or disputed, ask the treating team, NSW Trustee and Guardian, a lawyer, or another appropriate legal service.
What is different in NSW
NSW does not have a statutory advance care directive form in the same way most other states and territories do. Valid advance care directives are recognised under common law.
NSW Health provides an advance care directive form and booklet, but the form is not the only way to record a directive. Service NSW says a valid directive must be followed and cannot be overridden by health professionals or family members.
For a directive to be useful, it should be clear, specific, made voluntarily, and made while you had decision-making capacity. It also needs to apply to the situation that later arises.
What it can cover
Your directive can say what treatment you would accept or refuse if you later cannot decide. It may include CPR, artificial ventilation, tube feeding, IV fluids, antibiotics, hospital transfer, surgery, dialysis, blood transfusion, or comfort care.
It can also explain what matters to you. For example, you might say what level of awareness or recovery would make treatment worthwhile to you.
Because NSW does not use one compulsory form, clear wording matters. A broad statement such as "I do not want heroic measures" may be harder to apply than a statement that explains the illness, treatment or situation you had in mind. If you are refusing a treatment, say what treatment you mean and when the refusal should apply.
Who decides if you cannot
NSW uses the term "person responsible" for many health decisions when a person cannot decide for themselves. You can also appoint an enduring guardian for health and lifestyle decisions. Your directive should guide the person responsible, enduring guardian and treating team.
Someone else cannot make an advance care directive for you. They can help you write down your wishes while you still have capacity.
If there is disagreement, the treating team may need to look at the directive, the views of the person responsible or enduring guardian, and any other evidence of what you would have wanted. A clear directive, shared early, makes that easier.
What to do after making one
Talk with your GP or treating team before relying on detailed treatment instructions. Ask whether the wording is clear enough for the health situations you are worried about.
Give copies to your enduring guardian, person responsible, GP, hospital, aged care home and close family if you are comfortable doing so. NSW Health recommends uploading it to My Health Record.
Review the document after a major diagnosis, hospital admission, move into aged care, change in treatment goals, or change in the people you trust to speak for you. If you change it, destroy old copies or mark them as replaced so people do not rely on the wrong version.
You may also want to read
- What is an advance care directive?
- Can I refuse antibiotics, hospital transfer, tube feeding or other treatment in advance?
- Can I decide not to return to hospital?