Advance Directives
What is an advance directive?
An advance directive is an arrangement made by competent persons regarding their healthcare treatment in the eventuality that they might become incompetent to make their own healthcare decisions. Often, such directives are put in place to enable or allow natural death, such as making it clear that one does not wish to be resuscitated. Advance directives may be about the circumstances surrounding possible future treatment, the kinds of treatment, or by whom decisions should be made. There are two main kinds of advance directives, namely:
A “living will,” or statement of wishes, is a means by which a competent person provides guidance to others regarding the end-of-life choices they become incompetent to refuse such treatment themselves. For example, a person may complete and sign a document that specifies that they would prefer withholding or withdrawal of all medication, such as antibiotics, and including artificial nutrition and hydration, should they fall into a permanent vegetative state (PVS) or become irreversibly non-responsive.
A “section 7 mandate” is a legally binding document that is described in the National Health Act of 2003 whereby a person is appointed in writing to make healthcare decisions for you should you be incapable of doing so. Importantly, it is clear in the Act that mandated persons are legally empowered to make medical decisions on a user’s behalf and doctors must comply. The decisions and preferences of the mandated person should be respected AS IF the patient is making their own decisions.
It is very helpful for your mandated person, or you next of kin if a mandated person has not been appointed in writing, if you have communicated your wishes, ideally in a written document like a living will.