Advance care planning

If you were very sick and could not talk, how would your doctor know what treatments you want or do not want? Who will make medical decisions for you?

As a Peter Mac patient, you will need to make many decisions about your treatment and healthcare.

But if you were very sick and could not talk, how would your doctor know what treatment you want? Who will talk for you? How will they know what medical decisions to make for you -  what is important to you - and make sure your choices are respected?

What is advance care planning?

Advance care planning (ACP) means to think, plan and write down your wishes for your future healthcare. To predict what will happen to each of us and make decisions about the future is hard, and this is true for both patients and doctors. Sharing your values, wishes and choices with your loved ones and your doctors helps them to respect your choices. From the time of diagnosis, it is important to think about ACP.

Why is ACP important?

Writing down your values and choices is a good way to let people know what is most important to you. We know from research that if a patient does not talk about their preferences, it can be hard for doctors and families to know what they would have wanted. Importantly, we also know that if patients engage in advance care planning, their families have less anxiety, grief and depressions after they die.

Medical Treatment Planning and Decisions Act 2016

The Medical Treatment Planning and Decisions Act 2016 passed the Parliament on 24 November 2016, enshrining advance care directives in law. The changes will be implemented from 12 March 2018.

This establishes a single framework for medical treatment decision making for people without decision making capacity, which ensures that people receive medical treatment that is consistent with their preferences and values.

Victorians will be able to create a legally binding advance care directive that will allow them to:

  • Make an instructional directive (which will provide specific directives about treatment a person consents to or refuses).
  • Make a values directive (which will describe a person's views and values. A medical treatment decision maker and health practitioners will be required to give effect to a values directive).
  • Appoint a medical treatment decision maker (who will make decisions on behalf of a person when they no longer have decision making capacity).
  • Appoint a support person (who will assist a person to make decisions for themselves, by collecting and interpreting information or assisting the person to communicate their decisions).

There will be a stronger obligation for health professionals and health services to ask patients about advance care planning and advance directives.

A guide to advance care planning

Appoint someone to act as your Medical Treatment Decision Maker (MTDM)

Your appointed medical treatment decision maker (MTDM)  is a person you trust to make decisions for you if you are unable to. This person will represent the choices and values you have shared with them. This person used to be called a “medical power of attorney”. Importantly, this person only gets the power to make medical decisions for you if you cannot make them for yourself.

Chat and communicate

Think and talk about your quality of life and what is important if you became seriously unwell. Chat to your doctors and loved ones about what you would want and not want. Let them know what is important to you.

Ask your doctor and nurse about different treatment options and discuss those treatments you might want or not want.

Put it on paper

There are two types of advance directives

  • instructional directives which must be obeyed (link not available yet)
  • values directives (for example Peter Mac’s Statement of Choices)

Where can I get more advice about my advance care plan?

Speak to your treating team or social worker for help with advance care planning. If you have any queries about Advance Care Planning, you can email [email protected]

Remember you should give a copy of your completed form to your Medical Treatment Decision Maker, your family or friends, your doctors, your community palliative care team, any hospital you usually attend and your lawyer if you have one.

What do i do now?

If you were unwell, and unable to make medical decisions, WHO would speak for you and WHAT would they say?

  • Choose someone to act as your medical treatment decision maker
  • Talk to them about what choices you would want them to make for you if you were too unwell to make them yourself
  • Think about filling in forms to make sure everyone is aware of your choices. These could include appointing your selected person legally as your Medical Treatment Decision Maker, and filling out an advance directive (either an instructional directive, or a values directive)