Why make Advance Care Directives?

A properly prepared Advanced Care Directives is the only way for a person to ensure that, in the event they are injured or unwell, and are unable to express their wishes either temporarily or permanently, that those desires Medical personnel who receive treatment will be informed.

An Advanced Care Directives can only be made as long as a person has the capacity to make decisions (as defined in Section 4 of the Law) and can fully understand the instructions they are taking. In accordance with these provisions, it is recommended that anyone who updates a will consider making an advance directive at the same time.

Decision Making Of Medical Treatment and Support Person

The new legislation also allows a person to designate a medical treatment decision maker. According to the law a designee is one who makes decisions about the medical treatment of the person if the assesses is reasonably available and is ready to take medical treatment decisions.

A person can also nominate an individual as their support person. The support person can make communicate and give effect to the person's medical treatment decisions and represent the person's interests regarding the person's medical treatment.

In the event that a medical professional determines that a person lacks capacity, the medical professional must make every reasonable effort to determine whether the person has taken an Advanced Care Directives and / or designated a medical treatment decision maker.

Types of Advance Care Directives

There are two types of Advanced Care Directives that a person can choose to do: Instructional Directives and Values Directives.

An Instructional Directive is binding on medical professionals and describes any care that person specifically wishes or does not wish to receive in the future. An instructional directive may include, among other things, an address in relation to performing life-saving surgeries or the use of life support.

When being informed of the existence of an Instructional Directive, a medical professional should consider the instructions in that directive as if they were instructions that the patient has made directly to them.

A Values Directive identifies medical professionals the values ​​and preferences of the person making the directive. Examples of things that can be included in a Values Directive are the person's thoughts about end-of-life care, their views on the use of life support, their opinion about the treatment that is no longer effective or other considerations that may be relevant to your care. Making a Values 

Directive provides a medical professional with an idea of ​​the beliefs and attitudes of the person being treated in case the person can no longer transmit them to their treatment professional.

In the event that a person chooses to make a Values Directive without an Instructional Directive, the medical treatment decision maker must take into account the Values Directive when determining the best treatment for that person.

A person can choose to make an Instructional Directive and a Values Directive. The Instructional Directive will inform doctors about the patient's consent or refusal to treat and the Values Directive will be taken into account taking into account the opinions and values ​​of the person.

Requirements for Advanced Care Directives

Any person (including a child) can make an Advanced Care Directives, Provided that the person has the ability to make decisions regarding each statement in the instruction and understands the nature and effect of each statement in the instruction. To be considered valid, the directive must include the following details to be considered valid;

• The full name of the person making the Advanced Care Directives,
• The date of birth of the person making the Advanced Care Directives,
• The address of the person making the Advanced Care Directives,

It is also important that the creator sign an Advanced Care Directives in front of two independent adult witnesses. A witness must be a registered doctor and his qualification must be duly registered in the document. All parties that sign the document must do so in mutual presence. It is important to ensure that none of the witnesses to the document are the same person who has been designated as a medical treatment decision maker.

Each witness must certify that he has formed the opinion that;

• The creator has the capacity to execute the document;
• The creator understands the nature and effect of the statements made in his directive; 
• The document was signed voluntarily and was free from undue influence.

Cancel or Revoke Advanced Care Directives

A person may choose to revoke an advance directive at any time, provided he has the capacity to do so. To revoke an advance care directive, the person who provided the directive must complete a revocation form. Similar to the directive, the revocation form must be signed in front of two independent witnesses (not the medical treatment decision maker of the relevant person), and one of the witnesses must be a registered doctor.

An Advanced Care Directives will be cancelled when a person makes a new advance care directive or by order of the Civil and Administrative Court of SA.

An advance care directive ceases to take effect at the time your manufacturer dies.

Advance Care Directives and Powers Of Attorney

According to the Law on decisions and planning of medical treatment, a person can no longer issue a Powers of Attorney that gives him authority to make medical decisions for them. While lasting legal powers can still be taken in relation to lifestyle, financial and personal matters, providing a person with the authority to make decisions regarding medical treatment should now take the form of an Advanced Care Directives.

It is important to keep in mind that durable medical legal powers made before the start of the new legislation are still recognized in the new law.