Advance care directives

7 May 2014

This paper summarises policies, and public debates, about end-of-life care in New South Wales.


End-of-life care has been a topic of debate in Australia for several years and, with a rising aged population, is an issue that will only increase in importance. One part of the debate arises from the fact that persons approaching the end of their life often lose capacity to make their own treatment decisions. It has been suggested that this can result in stress for health professionals and families, who are left with the responsibility for making such decisions; and it can lead to the patient receiving unwanted and unnecessary treatment in acute care settings, with adverse outcomes for the patient and the health system.

Governments in Australia and overseas have promoted Advance Care Planning, including Advance Care Directives, as one way of addressing these issues. This e-brief begins with a brief history of this policy. It then outlines the debate about Advance Care Directives and presents evidence about their uptake and impact on care outcomes. Next, the paper presents a summary of government policy and law in NSW, and it notes a 2010 Parliamentary Committee report’s recommendation to consider whether legislation is needed in NSW. The final section outlines key features of legislation in other States and Territories.

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