Health Care DecisionsA person 18 years or older is legally presumed to be capable of making their own decisions, even if they have a health condition or disability that may affect their thinking (cognition), for example a diagnosis of dementia or schizophrenia.
Substitute Decision MakersSometimes however, their condition or disability may cause such an impact that they are not able to make some decisions, including about their own healthcare. Often a person can be supported by their network to allow them to make those decisions, called ‘supported decision making’, or informal decision making. Other times they may require another person to make decisions on their behalf, particularly if the decision is more complicated or they are extremely unwell at the time. The other person is often called a ‘substitute decision maker’. See also Substitute Decision Making.
This section talks about how a substitute decision maker is to make health care decisions.
- Enduring Power of Attorney
- Guardianship and Administration, and
- Statutory Health Attorney pages, as appropriate.
If you need to make a health care decision for someone else you should ask the health care provider questions that will help you to understand what type of treatment they are proposing, and what effect it will have. These may include:
- What is the medical condition?
- What does the treatment involve?
- What are the benefits of the treatment?
- What are the risks of the treatment?
- What are the consequences of not having the treatment?
- Is there alternative treatment available?
The Health Care Principle (How decisions are made)When making health care related decisions you must apply the Health Care Principles. The Health Care Principle states that power of a health care matter should be exercised in the least restrictive way. Additionally, that power should only be exercised if it is necessary and appropriate to maintain or promote the adult’s health or wellbeing; or if it is in the adult’s best interests.
Uncertainty about decisionsA decision-maker also has the right to ask for a second opinion in the same way that the adult could ask for a second opinion if they had the capacity to make decisions.
If you are confused or worried because you have been asked to make a major decision and you are not sure what is in the best interests of the adult, you might consider asking for a second opinion from another doctor or talk to the nurses or your family. If you are still undecided or you do not wish to make a decision, you may contact the Public Guardian for information on decision-making.
If there is disagreement between attorneys or statutory health attorneys about health care decisions, the Public Guardian may offer informal mediation to try to resolve disagreements. If unsuccessful, the Public Guardian is empowered to make the health care decision acting as statutory health attorney of last resort.
You can get more help and information by calling the Public Guardian on 1300 653 187.
Consent before health care treatmentIn most instances an adult’s consent is required before treatment. Consent is required for such things as (but not limited to)
- withholding or withdrawing life sustaining measures (find out more by reading the Public Guardians withholding and withdrawal of life sustaining measures framework).
Consent is not needed for
- urgent health care (treatment needed to meet imminent risks to the adult’s life or health or treatment to prevent significant pain or distress, and it is impracticable to get consent)
- minor and uncontroversial health care, provided it is necessary for the adult’s health and well-being and they do not object to the treatment such as:
- applying first aid
- taking blood pressure
- checking teeth
- giving medications normally obtained without a prescription
- giving antibiotics for a throat infection or asthma medication
- administering cough mixture
- a flu vaccination or eye drops
- giving a tetanus or hepatitis injection.
Refusal to consentIf you refuse to consent to the treatment, a health care provider may ask the Public Guardian to intervene if they believe the adult needs the medical treatment and that you are acting against the health care principle.
The Public Guardian will ask you how the decision was made and the reasons considered as part of that process. For example, the adult may have told you at some time in the past that they would not want to undergo specific treatment.
The Public Guardian then considers your explanation, information from the doctor and the principles contained in the law. The Public Guardian is empowered to make the health care decisions if you are acting contrary to the Health Care Principle.
Decisions that cannot be madeGuardians, attorneys for health matters and statutory health attorneys do not have the authority to consent to special health matters such as:
- donation of tissue
- termination of pregnancy
- participation in special medical research or experimental health care.
Page Reference: https://www.publicguardian.qld.gov.au/health-decisions/making-health-care-decisions-for-others