Medical Treatment Decision Maker
A ‘Medical Treatment Decision Maker’ is a document that appoints one or more people to make medical decisions on your behalf if you are not able to. The people you appoint will have the authority to make medical treatment decisions for you in conjunction with your treating doctor.
Who can be your Medical Treatment Decision Maker?
You may appoint anyone over the age of 18 to be your Medical Treatment Decision Maker but you should appoint someone you trust implicitly.
How do they work?
Your Medical Treatment Decision Maker document lists your decision makers. If you are in an accident or cannot otherwise make your own medical decisions because of an incapacity, the hospital or doctor will try to contact your decision makers. The person who makes the decision will be first person listed in the document who is reasonably available and willing and able to act at the particular time.
If your first listed medical decision maker cannot be reached, your second listed decision maker will be contacted and so on. It is usual for people to appoint up to 3 people who are usually a spouse and children.
Please be aware that your medical decision makers are not appointed to make decisions jointly. They are appointed in the specified order, so the doctor only need to confer with one person to make a medical decision. This is because in an emergency, there may not be time to have all decision makers confer and agree on a course of treatment.
Decisions that they cannot make on your behalf
Your decision makers cannot make decisions on your palliative care or special medical procedures. Palliative care is the provision of reasonable medical treatment for the relief of pain, suffering and discomfort and the provision of food and water. Special medical procedures include a termination of a pregnancy, a transplant or any procedure that is likely to render you infertile.
How can they be used?
Your Medical Treatment Decision Makers can request certified copies of your document which they can produce to a doctor or hospital.
Advanced Care Directives
An Advance Care Directive is document with your binding instructions or preferences and values in relation to your medical treatment in the event that you do not have decision-making capacity for that medical treatment. You can make this directive in consultation with your treating GP and your decision makers must refer to it when making a medical decision.
What Decisions can they make?
Your Medical Decision Maker will be given a proposed course of treatment from a doctor. They then must consider your Advanced Care Directive (if you have made one) and act in accordance with your preferences and values. If these are not known to your decision maker then they must consider the likely effects and consequences of the proposed medical treatment, any alternative to the treatment (including refusing the treatment) and act in good faith.
Is a Victorian Medical Treatment Decision Maker valid in other States?
Yes. All States and Territories recognise each other’s Medical Decision Makers and Financial Powers of Attorney, as long as they were made and witnessed in accordance with the laws of the State or Territory in which they were made.
When do the powers commence?
Your decision makers will only be called if you lose the mental capacity to make your own medical decisions or if you have an accident and are not able to make your own decision at that time.
Duties of your Medical Decision Makers
Essentially, your decision maker must make a decision they believe is the decision that you would have made if you had decision-making capacity. They must consider any values directive in your Advanced Care Directive, any relevant preferences you have expressed or that could be inferred from your life. If they are unable to ascertain your preferences, they must make a decision that promotes your personal and social wellbeing. In that circumstance, they may consult with anyone they believe you would want them to consult with regarding your treatment.
What if I do not make a Medical Treatment Decision Maker?
If you do not have a Medical Treatment Decision Maker appointed then the first of the following persons, who is willing to make a decision, will be called upon:
(a) your spouse or domestic partner;
(b) your primary carer;
(c) the first of the following and, if more than one person fits the description in the subparagraph, the oldest of those persons—
(i) an adult child;
(ii) a parent;
(iii) an adult sibling.