A medical treatment decision is a decision to either consent to or refuse medical treatment. The Medical Treatment Planning & Decision Act 2017 (Vic) commenced on 12 March 2018 and now governs medical treatment decision making in Victoria.
The Act:
Instructional directive
An instructional directive:
is a statement of your medical treatment decision
takes effect as if you had consented to, or refused, the medical treatment.
An illness or injury may mean that you do not have decision-making capacity to make medical treatment decisions. Other than in an emergency, your health practitioner must make reasonable efforts to find out whether you have made an advance care directive instructional directive. If you have, your health practitioner must follow the instructions in the directive.
To make an instructional directive, you can use the form for adults developed by Victoria’s Department of Health and Human Services.
https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/advance-care-planning
Value directive
A value directive is a statement of your values and preferences for your medical treatment. If you do not have decision-making capacity to make a medical treatment decision, and have not made a relevant instructional directive, your health practitioner will ask your medical treatment decision maker to make the decision on your behalf. To do this, they must consider, among other things:
To make a value directive, you can use the advance care directive form for adults developed by Victoria’s Department of Health and Human Services.
https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/advance-care-planning
Witnessing requirements
After you complete the advance care directive, you will need to sign the form in front of two witnesses. One of your witnesses must be a registered medical doctor. Neither witness can be someone you have appointed as your medical treatment decision maker.
Your witnesses will need to certify that you have decision-making capacity to complete the advance care directive, understood the nature and effect of each statement in your directive, and that you signed freely and voluntarily.
More key points
Medical Powers of Attorney made prior to 12 March 2018 will remain valid until revoked or expired. They will be considered Medical Treatment Decision Makers under the new legislation.
Where a health practitioner is unable to locate an advance care directive and/or a medical treatment decision maker, the health practitioner may proceed if the medical treatment is routine, but if the treatment is significant, the health practitioner must notify the Office of the Public Advocate.
For General Practitioners
Have you completed an Advance Care Directive for your patient?
Has your patient consented for this to be recorded in Western Health records?
If so, please fax a copy of the fully completed Advance Care Directive to:
GP Integration Unit
Fax: 8345 1180
Contacts for further information
Please speak to your treating team if you have with any questions about medical treatment planning during your admission. There are also the following external resources available: