One step forward, two steps back: advance care planning, Australian regulatory frameworks and the Australian Medical Association

Malcolm H. Parker, University of Queensland
C Stewart, Macquarie University
L Willmott, Queensland University of Technology
Colleen M. Cartwright, Southern Cross University

Abstract

The Australian Medical Association has recently adopted a policy position concerning advance care planning, which is generally supportive of extending patient self-determination beyond the loss of decision-making capacity. It calls for uniform national legislation for legally enforceable advance health directives (AHD), and statutory protection for practitioners who comply with valid AHD, or who do not comply on several grounds. Analysis of the grounds for non-compliance indicate that they undermine patient autonomy, and aspects of the policy are inconsistent with current common law and statutory regimes that allow an adult to complete a legally binding AHD. The policy therefore threatens the patient self-determination, which it endorses, and places doctors who participate in advance care planning at legal risk.