Understanding Advance Care Planning in Victoria
Advance Care Planning is the process of thinking about, discussing, and documenting your preferences for future health care. In Victoria, it provides a clear legal framework to ensure your wishes are understood and respected if you lose decision-making capacity due to illness, injury, or cognitive decline. At its heart, Advance Care Planning is about autonomy, dignity, and reducing uncertainty for those who may need to make decisions on your behalf.
The central legal document is the Advance Care Directive (ACD). This is a legally binding document that applies only when you no longer have capacity to make or communicate medical decisions. An ACD can include one or both of two components: a Values Directive and an Instructional Directive. Each serves a distinct but complementary role.
A Values Directive describes what matters most to you in life and in health care. It is not about specific treatments, but about your beliefs, priorities, and goals. This may include your views on quality of life, independence, pain management, spirituality, cultural considerations, and what you would consider an acceptable or unacceptable outcome. For example, you might state that being able to recognise loved ones is essential to your sense of dignity, or that comfort is more important to you than life prolongation at all costs. A Values Directive is especially important because it guides decision-makers in situations that cannot be predicted in advance. Doctors and your appointed Medical Treatment Decision Maker must consider these values when making decisions for you.
An Instructional Directive, on the other hand, is much more specific. It allows you to give legally binding instructions about particular medical treatments you consent to or refuse. This might include refusing cardiopulmonary resuscitation (CPR), artificial ventilation, or tube feeding in certain circumstances. If an Instructional Directive applies to the clinical situation, health practitioners are legally required to follow it. Because of its binding nature, it is important that Instructional Directives are carefully considered, clearly written, and reviewed over time as your circumstances or views change.
In addition to completing an Advance Care Directive, most people also appoint a Medical Treatment Decision Maker. This is a trusted person who can make medical decisions for you when you no longer can, guided by your Values Directive and any Instructional Directives you have made. Choosing the right person and ensuring they understand your wishes is just as important as completing the paperwork.
Advance Care Planning is not only for people who are older or seriously ill. Life is unpredictable, and having your wishes documented can provide peace of mind at any stage of adulthood. It can ease the emotional burden on families, reduce conflict, and support clearer communication with health professionals.
Ultimately, Advance Care Planning is an ongoing conversation, not a one-time task. Reviewing your documents regularly and talking openly with loved ones helps ensure your care reflects who you are, even when you can no longer speak for yourself.