Advance Care Directive Template
An advance care directive (also known as a living will or advance health directive) records your wishes for medical treatment if you lose decision-making capacity. Use our free Australian template to set out your treatment preferences, values, and appointed decision-maker, aligned with your state's advance care planning legislation.
| FULL LEGAL NAME | James T. O'Brien |
| DATE OF BIRTH | 3 November 1958 |
| ADDRESS | 45 George Street, Sydney NSW 2000 |
| STATE | Victoria |
| DATE OF DIRECTIVE | 25 April 2026 |
| GOVERNING ACT | Medical Treatment Planning and Decisions Act 2016 (Vic) |
| MEDICARE NO. | 5432 10987 3 |
| FULL NAME | Sarah J. Mitchell |
| RELATIONSHIP | Sister |
| PHONE | +61 2 9876 5432 |
| ADDRESS | 12 Wattle Drive, Doncaster VIC 3108 |
| ALTERNATE DECISION-MAKER | Patrick D. O'Brien · +61 412 345 678 |
1. APPOINTMENT OF SUBSTITUTE DECISION-MAKER. I appoint Sarah J. Mitchell (my Sister), telephone: +61 2 9876 5432, as my substitute decision-maker to make healthcare decisions on my behalf if I am unable to make or communicate decisions myself. My decision-maker must act consistently with the wishes expressed in this directive and, where my wishes are unclear, must act in my best interests. If my primary decision-maker is unable or unwilling to act, I appoint Patrick D. O'Brien (telephone: +61 412 345 678) as my alternate.
2. LIFE-SUSTAINING TREATMENT. I direct that life-sustaining treatments be provided only where there is a reasonable prospect of recovery to a quality of life I would consider acceptable. If my treating medical team determines that my condition is terminal with no reasonable prospect of recovery, or that I am in a persistent vegetative state, I direct that life-sustaining measures be withheld or withdrawn, and that I receive comfort care only.
3. SPECIFIC TREATMENT PREFERENCES.
Cardiopulmonary Resuscitation (CPR): I do not consent to cardiopulmonary resuscitation (CPR). I direct that a Not for Resuscitation (NFR) order be placed on my medical records.
Mechanical Ventilation: I consent to a time-limited trial of mechanical ventilation. If there is no meaningful improvement within a period determined by my treating team, I direct that ventilation be withdrawn.
Artificial Nutrition and Hydration: I consent to short-term artificial nutrition and hydration only. If my condition does not improve meaningfully, I direct that artificial nutrition be withdrawn.
4. PAIN MANAGEMENT AND PALLIATIVE CARE. I direct that I receive maximum available pain relief and palliative medication to keep me comfortable, even if such medication may have the secondary effect of hastening death. Comfort and freedom from pain are my primary concern.
5. ADDITIONAL HEALTHCARE INSTRUCTIONS. I wish to remain at home or in a hospice setting for end-of-life care where possible. Religious and cultural considerations: Catholic faith; I welcome pastoral visits and last rites.
6. ORGAN AND TISSUE DONATION. I wish to donate all viable organs and tissues upon my death for transplantation, medical research, or education. I authorise my substitute decision-maker and appropriate medical personnel to facilitate this in accordance with state human tissue legislation.
7. GENERAL PROVISIONS.
Capacity: I make this directive while I have full mental capacity to do so and understand the nature and effect of each direction.
Revocation: I may revoke or amend this directive at any time while I have decision-making capacity. Any revocation must be in writing and signed in the presence of a witness.
Copies: A photocopy of this directive has the same force and effect as the original. I direct that copies be given to my substitute decision-maker, my general practitioner, and any hospital or aged care facility where I receive treatment.
Governing Law: This directive is made under and shall be interpreted in accordance with the Medical Treatment Planning and Decisions Act 2016 (Vic) and any applicable Commonwealth legislation.
I, James T. O'Brien, of 45 George Street, Sydney NSW 2000, in the State of VIC, being of sound mind and understanding, make this Advance Care Directive to express my wishes regarding healthcare decisions in the event that I become unable to make or communicate such decisions for myself. This directive is made in accordance with the Medical Treatment Planning and Decisions Act 2016 (Vic).
| FULL NAME | Dr. Priya Sharma |
| ADDRESS | 50 Station Street, Box Hill VIC 3128 |
| CATEGORY | Medical Practitioner |
| FULL NAME | Robert T. Harrington |
| ADDRESS | 8 Collins Street, Melbourne VIC 3000 |
Two adult witnesses are required in most Australian states. At least one witness must not be a relative, carer, or a person who may benefit from the declarant's estate. Requirements vary — refer to the applicable state legislation.
Robert T. Harrington · 8 Collins Street, Melbourne VIC 3000
What Is an Advance Care Directive?
An advance care directive is a legal document that records your wishes, values, and instructions for future medical treatment in the event you lose the capacity to make or communicate decisions. It may include binding refusals of specific treatments (such as cardiopulmonary resuscitation or artificial ventilation), statements of values and goals of care, and the appointment of a substitute decision-maker. It speaks for you when you cannot speak for yourself.
Advance care planning in Australia is governed state-by-state. Each jurisdiction has its own framework: Advance Care Directives Act 2013 (SA), Powers of Attorney Act 2006 (ACT), Advance Personal Planning Act 2013 (NT), Guardianship and Administration Act 2000 (Qld) (through an Advance Health Directive), Medical Treatment Planning and Decisions Act 2016 (Vic), Guardianship and Administration Act 1990 (WA), Guardianship and Administration Act 1995 (Tas), and for NSW, a common-law advance care directive (the Guardianship Act 1987 (NSW) is currently under review).
A valid Australian advance care directive must generally be made voluntarily by a person with decision-making capacity, be in writing, signed, and witnessed as required by the state or territory legislation. It applies when the person loses capacity. Australian health practitioners are legally required to respect a valid and applicable advance care directive, with limited exceptions (such as where compliance would be inconsistent with good medical practice or where the person has changed their mind).
What's Covered in This Template
Our advance care directive template helps you record your medical treatment wishes and appoint a trusted decision-maker.
Personal Details
Your full name, address, date of birth, and Medicare number.
Values and Goals of Care
Your personal values, beliefs, and what constitutes an acceptable quality of life.
Substitute Decision-Maker
Appointment of an attorney or enduring guardian to make decisions on your behalf.
Treatments You Refuse
Specific treatments you do not want, such as CPR, ventilation, or artificial feeding.
Treatments You Accept
Treatments you consent to, including palliative care and pain management.
End-of-Life Preferences
Preferred location of care (home, hospital, hospice) and organ donation wishes.
Religious or Cultural Considerations
Religious practices, cultural beliefs, and cultural care preferences.
General Practitioner Details
Name and contact of your usual GP and specialists.
Witnessing
Witnessing by an authorised witness as required by state legislation.
Review and Revocation
Process for revising or revoking the directive.
Distribution
List of copies provided to family, doctor, and hospital.
Statement of Capacity
Declaration of capacity at the time of making the directive.
How to Create an Advance Care Directive
Follow these steps to produce a considered, legally effective directive in minutes.
- 1
Enter Your Personal Details
Provide your name, address, date of birth, and Medicare details.
- 2
Record Values and Preferences
Describe what quality of life means to you, and your overall goals of care.
- 3
Appoint a Substitute Decision-Maker
Name a trusted person to make medical decisions on your behalf.
- 4
Specify Treatment Choices
Identify treatments you refuse and treatments you consent to.
- 5
Witness and Download
Sign in front of an authorised witness as required by your state, and download the PDF.
Legal Considerations
Advance care directives are governed by state and territory legislation with differing formal requirements.
This template is for informational purposes only and does not constitute legal or medical advice. Advance care planning is highly personal — consult your GP and, where appropriate, a solicitor, before finalising your directive.
Reviewed for Australian law
State-Specific Frameworks
Each jurisdiction has its own legislation: Advance Care Directives Act 2013 (SA); Medical Treatment Planning and Decisions Act 2016 (Vic) (creating instructional and values directives); Powers of Attorney Act 1998 (Qld) (Advance Health Directive); Advance Personal Planning Act 2013 (NT); Guardianship and Administration Act 1990 (WA); Guardianship and Administration Act 1995 (Tas); Powers of Attorney Act 2006 (ACT); and in NSW, advance care directives operate at common law while the Guardianship Act 1987 (NSW) governs substitute decision-making.
Capacity Requirements
Under Australian law, an advance care directive is only valid if made voluntarily by a person with decision-making capacity at the time of making the directive. Capacity requires understanding the nature and effect of the directive and the ability to communicate the decision. Where capacity is in doubt, a medical assessment by an Australian registered practitioner is prudent.
Binding Effect on Health Practitioners
A valid and applicable advance care directive is legally binding on Australian health practitioners. Refusal of treatment in the directive must be respected even if the refusal would result in death (Hunter and New England Area Health Service v A (2009) 74 NSWLR 88). Limited exceptions apply where the directive is not applicable to the circumstances, has been revoked, or where an emergency requires immediate treatment inconsistent with the directive.
Interaction with Enduring Power of Attorney
Many Australians appoint an Enduring Power of Attorney (Personal) or Enduring Guardian to make decisions if capacity is lost. The advance care directive can specify that the appointed person must act in accordance with the directive. In Victoria, these instruments have been consolidated into medical treatment decision-makers under the 2016 Act, making Victoria one of the most reformed Australian jurisdictions in this area.
Frequently Asked Questions
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