ACT Advance Directive vs Power of Attorney: What Each One Does

People often treat "advance directive" and "power of attorney" as interchangeable, or assume one makes the other unnecessary. In the ACT, they do fundamentally different things, and leaving out either one creates a specific gap in your coverage.

What Each Document Does

The Health Direction (the ACT's version of an advance directive) is a first-person instruction. You are telling doctors directly: refuse or withdraw these specific treatments. It is legally binding on clinicians under the Medical Treatment (Health Directions) Act 2006. No one else needs to act on your behalf — the document speaks for you.

The Enduring Power of Attorney appoints a person to make decisions for you when you lose capacity. Under the Powers of Attorney Act 2006, your attorney can consent to treatments, and can refuse or withdraw treatment only if the EPoA expressly authorises it and the statutory conditions are met. The attorney can also choose care facilities, manage finances, and make personal care decisions within the powers granted. The EPoA requires a human intermediary — your appointed attorney — to interpret and implement your wishes in real time.

Where One Fails Without the Other

A Health Direction without an EPoA covers only treatment refusals. If a new medical situation arises that your Health Direction does not address — an unexpected complication, a choice between two treatment options, a decision about surgery — there is no appointed attorney with authority to decide for you. Doctors would need to identify a statutory Health Attorney from your family hierarchy, and that person cannot refuse life-sustaining treatment on your behalf. If family members disagree, the case gets referred to ACAT for a formal guardianship order, potentially delaying decisions during a medical crisis.

An EPoA without a Health Direction covers decision-making, including healthcare decisions within the powers granted. Your attorney can make legally effective substitute decisions within the scope of the EPoA and its statutory limits. A Health Direction is a direct instruction about specific treatment refusals or withdrawals that clinicians must follow when its requirements are met.

How They Interact (The Chronological Hierarchy)

The ACT has a specific rule about the interaction between these documents. Under section 19 of the Medical Treatment (Health Directions) Act 2006:

• If the documents are consistent, the attorney must comply with the Health Direction when making a decision about a healthcare or medical research matter
• If they are inconsistent, the attorney must comply with the EPoA when the Health Direction was made first, and with the Health Direction when the Health Direction was made after the EPoA

The safe approach, when you want a later Health Direction to control an inconsistent treatment decision, is to sign the EPoA first, then sign the Health Direction. Make the wording consistent wherever possible.

The Statement of Choices: The Third Piece

The ACT adds a third instrument — the Statement of Choices — that rounds out the picture. This non-binding document captures your values, preferences, and quality-of-life thresholds. It helps your attorney and clinical team make decisions that align with who you are, not just what treatments you want refused.

Think of it this way: the Health Direction says "no ventilator," the EPoA says "my daughter decides everything else," and the Statement of Choices says "I value being able to recognise my grandchildren more than I value an extra six months."

Which Do You Need?

Both. Plus the Statement of Choices. The ACT's tripartite system is deliberately comprehensive — each instrument covers a gap that the others cannot. Completing only one or two leaves specific vulnerabilities that surface during exactly the situations you are trying to plan for.

The ACT Advance Directive & Living Will Kit guides you through all three documents in the correct execution order, with cross-referencing between your Health Direction refusals and your EPoA powers so there are no conflicts or accidental revocations.

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