End of life treatment

Consultation with family and carers

Health practitioners should consult with family members and carers about medical treatment options for a patient who lacks decision-making capacity.

A principle of the Medical Treatment Planning and Decisions Act that a partnership is important to achieve the best possible outcomes. This is because the health practitioner brings their expertise about the medical condition and treatment options and the family members and carers bring their expertise about the preferences and values of the person.

No requirement to offer futile or non-beneficial treatment

Nothing in the Medical Treatment Planning and Decisions Act requires a health practitioner to administer futile or non-beneficial medical treatment. Health practitioners should exercise their own clinical judgement to determine if there is medical treatment which can be offered.

When there is no family or medical treatment decision maker

Whether medical treatment should be offered is a clinical decision for a health practitioner.

It is only if medical treatment is offered that it is necessary to request a medical treatment decision maker to make a medical treatment decision. If there are no family members or others interested in the welfare of the person, then clearly there is no one to advise that there are no treatment options and that possibly the person is approaching end of life.

When you would contact OPA

OPA acts as medical treatment decision maker in two circumstances:

  1. If the Public Advocate has been appointed guardian to make medical treatment decisions
  2. If the person does not have a medical treatment decision maker, then the Public Advocate can make decisions about significant treatment\

If medical treatment is not being offered then, from an advocacy perspective, OPA will want to ensure that the determination of the health practitioner is a clinically formed view and not a discriminatory presumption about the quality of life of a person with a disability. However, OPA is not able to provide any clinical view as to whether the decision not to offer treatment is clinically a sound determination. Health practitioners should consult with their peers and superiors for this input.

If no medical treatment is to be offered then there is no medical treatment decision to be made. Therefore, there is no need for any health practitioner to contact OPA to advise that no medical treatment is to be offered to a person, whether or not the person is expected to die.

Downloadable Resources

Further information