Speeches and Op-eds
Key considerations - Advance Care Planning
On Friday, 9 August 2019, the Acting Public Advocate, Dr John Chesterman, spoke at a state Advance Care Planning Forum, that drew more than 200 people (mostly health professionals) from around the state held at the Peter MacCallum cancer centre.
At the forum I spoke about OPA’s reflections on the first full year of operation of the Medical Treatment Planning and Decisions Act, and I spoke about the Act’s two central, and quite discrete, elements:
- its advance planning provisions (concerning the two kinds of advance directives that can be completed, and the appointment of Medical Treatment Decision Makers and Support Persons); and
- the consent processes required by the Act.
The three key points I made about advance care planning were that:
- ACP must be done by and with the person, not for them. Everyone can be encouraged to think about ACP, but no-one should be required to do it (e.g. as a condition of entry to a residential aged care facility).
- Rather than documents, conversations are the most important elements of ACP.
- When it comes to the future health treatment of people who may not have capacity to make treatment decisions, the question is not ‘how to do ACP for them?’, but how is the relevant medical treatment decision maker informed about the person’s values and preferences?
The three points I made about the Act’s consent provisions were that:
- Other than in specified circumstances, consent by the person, or their medical treatment decision maker, is required before medical treatment is provided.
- When it is needed, support should be provided to assist people to make their own treatment decisions.
- When a person does not have capacity to make a treatment decision, the medical treatment decision maker (or OPA in ‘significant treatment’ situations when there is no medical treatment decision maker) must make the decision the person would likely have made.
The form, ‘What I understand to be the person’s preferences and values’, is available to download from the Northern Health website >