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 the decision-making principles.

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;
maintaining the person’s freedom of decision and action to the greatest extent possible;
providing the person with appropriate care, including health care;
maintaining the person‘s right to be treated with dignity and respect; and
protecting 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 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 does not 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 the circumstances.