Advance Care Directive for a Minor (16–17) in Tasmania

When most people think about advance care directives, they picture someone in their 60s or 70s planning for cognitive decline. But Tasmanian law doesn't restrict ACDs to adults. A young person aged 16 or 17 can make a legally valid advance care directive — and for those living with serious illness, it's not a hypothetical exercise.

Who this applies to

The typical situation isn't a healthy teenager planning decades ahead. It's a young person with a life-limiting condition — advanced cancer, a degenerative neurological disease, cystic fibrosis with declining lung function, or a congenital heart condition — who wants to document their treatment preferences while they still have full decision-making capacity.

It also applies to young people with chronic mental health conditions who want to record their treatment preferences during a period of stability, in case they later lose capacity during a crisis.

In these situations, an advance care directive gives the young person legal control over their own medical treatment. Without one, decisions default to parents or TASCAT-appointed guardians — which may not reflect what the young person actually wants.

The extra witnessing requirement

A minor (under 18) can make an ACD in Tasmania using the same approved Tasmanian Health Service form as an adult. The content rules are identical: binding treatment refusals, value statements, and care preferences.

The difference is in the witnessing. For an adult, two independent adult witnesses are required. For a declarant under 18, at least one of the two witnesses must be a registered health practitioner — a doctor, nurse, or other registered health professional.

This additional safeguard serves two purposes: the registered health practitioner must be qualified to attest that the young person is sufficiently mature to make these decisions, and their signature records that statutory assessment if the ACD is ever challenged.

All the standard witness disqualifications still apply. Neither witness can be:

• A close relative of the declarant
• The appointed enduring guardian
• A direct paid carer
• A staff member or administrator of a residential facility where the declarant lives
• A beneficiary of the declarant's estate

Capacity for minors: what doctors assess

Under 18, the declarant must be sufficiently mature to understand what an advance care directive is and the consequences of making one. For a 16 or 17-year-old, the registered health practitioner witness must be qualified to attest to that maturity. The treating specialist or GP will typically confirm that the young person:

• Understands their medical condition and prognosis
• Comprehends the specific treatments they're consenting to or refusing
• Appreciates the consequences of those refusals (including that refusing treatment could result in death)
• Is making the decision voluntarily, without coercion from parents, siblings, or clinical staff

A written capacity assessment from the treating doctor, stored alongside the executed ACD, significantly strengthens the directive against future legal challenge.

What about enduring guardianship?

An enduring guardian must be at least 18 years old, and the person applying to appoint one must also be 18 or over. A minor therefore cannot appoint an enduring guardian. An EG appointment can be considered once the young person reaches adulthood, provided they still have decision-making ability.

For a young person with a progressive condition who is currently 17 and may lose capacity after turning 18, the EG appointment should be revisited once they turn 18, while decision-making ability is clear.

The role of parents

Parents don't need to co-sign or approve a minor's ACD in Tasmania. The directive is the young person's own legal document. However, involving parents in the process (with the young person's consent) is almost always beneficial:

• Parents who understand the ACD can advocate for it to be followed if clinical staff hesitate
• Family alignment reduces the risk of a parent seeking to override the directive during a crisis
• The palliative care team can facilitate a joint conversation that addresses everyone's concerns

If parents actively oppose the young person's treatment preferences, the ACD still stands legally — but the practical reality of enforcing it in a clinical setting is harder. In those cases, the treating team and the young person may want to involve a social worker or patient advocate.

Registration

The registration process is the same as for adults. The completed ACD can be submitted to TASCAT for registration (free of charge) and uploaded to My Health Record through MyGov. Registration isn't mandatory, but for a minor — whose ACD may face more scrutiny than an adult's — registration adds a layer of official recognition that makes it harder to dismiss.

Getting it right

For a young person facing serious illness, an advance care directive is one of the few things that gives them agency in a situation where they otherwise have very little control. The paperwork matters, but the conversation — with parents, with the treating team, with anyone who might need to advocate for the young person's wishes — matters more.

The Tasmania Advance Directive & Living Will Kit includes the full witnessing requirements for minors, capacity assessment guidance, and the step-by-step registration process for TASCAT and My Health Record.

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