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Guidelines and Policies

Developing and Using Advance Care Directives NSW
NSW Health
The guide aims to assist health professionals to discuss advanced care planning with patients, and to clarify how to use an advanced care directive as part of that process.

End of Life Care Decision Making Guidelines NSW
NSW Health
Guidelines set out a process of decision making in regards to end-of-life.

The Role of the Medical Practitioner in Advance Care Planning Australia
Australian Medical Association
AMA policy on Advance Care Planning.

Advance Planning for Quality Care at End of Life – Action Plan 2013–2018 NSW
NSW Health

Toolkits and Protocols

Advance Care Directives NSW
Department of Health,  NSW

Advance Care Planning
Care Search

Advance Care Planning – It’s all about talking…
NSW Department of Health

Advance Care Planning and Advance Directives
Ethics & Health Law News

Advance Care Planning Training Resouce Australia
Palliative Care Australia
Training resource on Advance Care Planning, including legal aspects.

Advance Directives: The Legal Issues [PDF]    Vic
Office of the Public Advocate: Victoria
Overview of the legal status and legal issues of Advance Directives.

Advance Care Planning Australia
Royal Australia College of General Practitioners
Guides and documents for all Australian jurisdictions

Cases

Hunter New England Area Health Service v A [2009] NSWSC 761 NSW
The case concerns a unconscious patient who had an advance care directive refusing certain treatments. Issues: whether directive was a valid indication of patient’s desire and whether patient had capacity to make the directive. Provides an excellent summary of the principles on consent and advance care directives.

Local Health Authority v E [2012] EWHC 1639 (COP) UK
The Court of Protection found a 32-year-old woman suffering from extremely severe anorexia nervosa to be incompetent to make a directive on two previous occasions even though they had been executed in the presence of health professionals. The health professionals had not made a full assessment of her capacity and there were reasons to doubt it. She had also acted in ways which were inconsistent with the directives.

Papers, Reports and Books

Determining the Validity of Advance Directives
(2000) 172 Med J Aust 545
Authors: Paul Biegler, Cameron Stewart, Julian Savulescu and Loane Skene
Examines the ethical principles underpinning advance directives (ADs) and the legal duties of doctors in determining their validity.

Dworkin on Dementia: Elegant Theory Questionable Policy
Rebecca Dresser,  25 (6) The Hastings Center Report, 32-38.
A reply to Dworkin’s argument for following advanced directives in cases of dementia, noting that when a person remains able to enjoy and participate in their lives advanced directives should sometimes be ignored.

National Framework for Advance Care Directives (Draft)[PDF]
Australian Health Ministers’ Advisory Council (AHMAC) 2011
Describes the goals that should drive the policy formulation of advances directives across Australia. The Framework includes a Code for Ethical practice and a set of Best Practice Standards.

The retreat from advanced care planning
Tinetti, ME (2012) 307(9) JAMA 915-16.

When death is imminent: Documenting end-of-life decisions
Amanda Gaw, Steven Doherty, Philip Hungerford, Jenny May, (2012) 41 (8) Australian Family Physician 614-617.
This study suggests that documented advance care plans are either not being prepared in the community or are not being communicated to acute care facilities. As a result, end-of-life care preferences are documented when death is imminent.

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