Linda Nolte explains the role of advance care planning in the context of the recently introduced voluntary assisted dying laws.

With voluntary assisted dying (VAD) now a legal option in WA, it marks a significant change in the end-of-life care landscape. 

Linda Nolte

Advance care planning (ACP) is known to improve end-of-life care and should be a priority consideration for West Australians and their health professionals.

While ACP and VAD are frequently conflated in the community, they are two distinct and separate actions. In short, VAD is a decision to end one’s life, while ACP gives a person choice and control over future medical decisions and how they want to live out the rest of their life. 

Advance care planning enables people to make choices about the care they want to receive if they become too unwell to speak for themselves. It puts the individual in the driver’s seat, providing a sense of control when facing chronic or progressive disease, cancer, dementia or just old age.

Only 15% of older Australians have documented their future preferences in an Advance Care Directive (also known as an Advance Health Directive in WA).

In a time when the community is seeking greater choice and autonomy over their own care, it is disappointing that so many people are leaving their future medical decisions for others to choose.

VAD/AHD considerations
  • VAD laws require that the person has decision-making capacity – from the time of request through to the final act.
  • An Advance Health Directive (AHD) remains valid and will be respected even if the person loses decision-making capacity.
  • An AHD can include instructions to refuse, consent or withdraw from treatment.
  • A person cannot make a request for VAD in their AHD.
  • A person’s substitute decision-maker (guardian) is not permitted to request VAD on behalf of a loved one.
  • VAD should not be considered a substitute for quality ACP or palliative care. 
  • In the context of a person making a VAD request, ready access to advance care planning, as well as quality palliative care is essential.

It is important to remember that in countries and jurisdictions where VAD is legal, eligibility criteria are restrictive, meaning it is ultimately an option for only a few, whereas advance care planning is and remains accessible and relevant to all adults, regardless of their health status or age.

Key facts about ACP
  • About 30% of people will not be able to make their own end-of-life medical decisions.
  • A third of Australians will die before the age of 75.
  • Most people die after a chronic illness, not a sudden event.

Research shows that advance care planning can reduce anxiety, depression and stress.

Advance Care Planning Australia supports the public and healthcare professionals with a dedicated website with access to jurisdictional forms and legal information.

There is free phone support on 1300 208 582, Monday-Friday, 9am-5pm (AEST). 

ED: Linda Nolte is program director at Advance Care Planning Australia.