End of Life Law in Australia

How do substitute decision-makers make decisions?

How do substitute decision-makers make decisions?

When deciding whether or not to consent to health care for a person at the end of life, an Advance Personal Plan decision-maker must act in accordance with decision-making principles in the APP Act.

Guardians must act in accordance with the guardianship principles which require the guardian to act and make decisions in the person’s best interests. This includes considering:

  • the person’s current and previously stated views and wishes;
  • any views and wishes of an interested person for the adult;
  • maintenance of the person’s freedom of decision and action to the greatest extent possible;
  • provision to the person of appropriate care, including health care;
    maintenance of the person‘s right to be treated with dignity and respect; and
  • protection of the person from harm, neglect, abuse and exploitation.

A guardian should also decide in a way that is least restrictive of the person’s freedom of decision and action, and support the person as much as possible to make a decision for themselves.

Where the person has made an advance care statement, the guardian must follow and give effect to the statement even if it is not in the person’s best interests. The only exceptions to this are:

  • If the person still has capacity and states he or she doesn’t want to give effect to the statement.
  • It is impracticable, unlawful, onerous or unreasonable to make the decision the person would have made.
  • There is no reasonable possibility the person would have intended the advance care statement to apply in those circumstances.