Legal and Ethical Issues Surrounding Advance Care Directives in Australia: Implications for the Advance Care Planning Document in the Australian My Health Record

 Aims & Method: This literature review and discussion examined the legal and ethical issues relating to Advance Care Planning and Advance Care Directives in Australia. The review examined peer-reviewed articles written prior to 2010 to maintain a current view of the law. Twenty-seven articles were reviewed and discussed.

Results: An ACD gives individuals the autonomy to determine the care they will receive in the future, when they are no longer able to express those wishes. People are empowered by the opportunity to control their own care, as the ACD reduces the risk of receiving unwanted medical procedures. The ACP process may also reduce family conflict caused by differing motivations or opinions among family members about medical care.

However, legal and ethical barriers exist that may limit use of ACDs. Reviewed articles raised the key issue that people lack awareness and knowledge of the legal nature, purpose and benefits of ACP. Poor knowledge and understanding of the law surrounding ACP and ACDs may be improved through greater collaboration between healthcare practitioners and legal professionals. This will ensure that an ACD is written in a way that is legally binding, clearly states a patient’s wishes and is also clear for their doctor to interpret. This collaboration may also have benefits in guiding implementation of ACDs. Doctors must navigate complex legal issues to determine legal capacity to make decisions, and in identifying the validity of ACP and ACDs.

Implications: Identified barriers to ACP and ACDs must be overcome to ensure that patients are able to document their preferences for future health care. The My Health Record provides an accessible way to store ACP decisions and ACDs so that these documents are accessible to healthcare professionals when they are needed. This access is vital to ensure that ACDs are implemented as intended by the patients who make them.

Our onward queries: Given the lack of other suitable storage options for ACP and ACDs, it is concerning that so few Australians are using the ACPD function of the My Health Record. Collaboration and cross-promotion between legal information websites and the MyHR may improve awareness and uptake of this system. What awareness and understanding do legal professionals have of the MyHR and the role it can play in storing ACP and ACD documents for future access?

Full reference of article:
McCarthy, S., Meredith, J., Bryant, L., & Hemsley, B. (2017). Legal and Ethical Issues Surrounding Advance Care Directives in Australia: Implications for the Advance Care Planning Document in the Australian My Health Record. Journal of Law and Medicine, 25(1), 136-149.

Link to article on publisher page: http://sites.thomsonreuters.com.au/journals/2017/11/15/journal-of-law-and-medicine-update-vol-25-pt-1/