Advance Care Directive Mistakes to Avoid in South Australia
These Mistakes Can Invalidate or Undermine the Document
An Advance Care Directive in South Australia isn't like a contract where a minor error can be patched with an amendment. Some execution errors can make the ACD invalid, while other mistakes make it harder for clinicians to use. Where execution is invalid, you'd need to start fresh with a new form.
Here are the mistakes that invalidate directives or render them practically useless, in order of how often they occur.
Mistake 1: Wrong Signing Sequence
This is the single most common execution error. The Regulations require a strict signing order:
- All appointed SDMs sign their acceptance sections
- The principal signs in the presence of the witness
- The witness signs
If you book a JP, sign the form, and then send it to your SDMs to sign their acceptance pages afterwards, the document is invalid. The witness certified a document that wasn't properly executed at the time of witnessing.
How to avoid it: Get every SDM signature before you schedule the witness appointment. Since the 2024 amendments, SDMs can sign digitally — so interstate or overseas family members can complete their sections electronically and return the form before you arrange the in-person witnessed signing.
Mistake 2: Using a Disqualified Witness
South Australia's witness eligibility rules are stricter than for most other legal documents. The authorised witness must come from a prescribed professional category (JP, lawyer, registered health practitioner, social worker, police officer, or teacher) — but even someone from the right profession is disqualified if they're:
- An appointed SDM
- A beneficiary of your will
- Your treating clinician
- A relative
- A staff member in a position of authority at your care facility
The trap: your daughter is a solicitor. She's an authorised professional. But she's a relative, so she's disqualified. Your GP has known you for 30 years and you trust them completely — but if they're your current treating doctor, they can't witness your ACD.
How to avoid it: Before the appointment, run through the disqualification list with your chosen witness. If there's any overlap, find someone else. A JP at your local courthouse who has no personal connection to you is often the simplest choice.
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Mistake 3: Writing Vague Treatment Instructions
This mistake doesn't invalidate the document, but it makes it practically useless when it matters most. Under the Act, there's a clear distinction between a "binding provision" (which clinicians must follow) and a "non-binding value statement" (which they should consider but can override).
The difference is clinical precision. Phrases that sound definitive to you sound hopelessly vague to a doctor making emergency treatment decisions:
- "No heroic measures" — what counts as heroic? CPR? Antibiotics? A blood transfusion?
- "Let nature take its course" — does this mean no treatment at all, or just no life-support machines?
- "I don't want to be a burden" — this is a value, not a medical instruction
If your instruction is too vague to act on, clinicians will classify it as non-binding and default to preserving life. Your heartfelt wishes get reduced to a note in the file that nobody is legally required to follow.
How to avoid it: Name specific treatments you refuse and the clinical circumstances under which the refusal applies. "I refuse cardiopulmonary resuscitation and mechanical ventilation if I have an irreversible terminal illness with no reasonable prospect of recovery" is binding. "No heroic measures" is not.
Mistake 4: Using the Old Form
The ACD form was redesigned following the 2024 amendments. The post-March 2024 version includes sections for health conditions, organ donation preferences, and the expanded capacity to list up to four SDMs directly on the primary document.
Using a pre-2024 form isn't automatically invalidating — the older forms are still legally recognised — but they lack the structural improvements that make the newer form clearer for clinicians to interpret. More importantly, if you need to list more than four SDMs, you'd need the supplementary form as well, adding another document to track.
How to avoid it: Download the current form from the SA Health website. If you picked up a form from Service SA or a library, check the version date.
Mistake 5: Not Distributing Copies
South Australia has no centralised government registry for ACDs. If your directive exists only as a single physical document in a filing cabinet at home, it might as well not exist during an emergency hospital admission.
When a medical decision is required, the treating team checks your medical file, the hospital's records, and My Health Record. If no valid ACD or SDM is available, the team uses the default statutory hierarchy.
How to avoid it: After execution, distribute certified copies to every appointed SDM, your GP, your regular hospital, and any aged care facility you're in. Upload a digital scan to My Health Record. Consider carrying a wallet card that states you have an ACD and where it's stored.
Mistake 6: Appointing the Wrong SDM
This isn't a legal error — the document will still be valid. But appointing an SDM who won't or can't carry out your wishes defeats the purpose.
Common problems:
- The SDM who can't say no to the family. When your children are crying at the bedside wanting "everything done," can your SDM hold firm and enforce your documented refusal of life-support?
- The unreachable SDM. Your SDM travels extensively or lives in a remote area with poor phone coverage. The clinical team needs consent decisions within hours, not days.
- The SDM who doesn't understand your values. You had one conversation five years ago. They've forgotten the specifics. Under pressure, they default to what they'd want for themselves, not what you documented.
How to avoid it: Choose SDMs based on their willingness to advocate for your wishes, not just their personal closeness to you. Have a detailed conversation about your ACD's contents. Appoint backup SDMs in case your first choice is unavailable.
Mistake 7: Assuming the ACD Covers Everything
The ACD is powerful but bounded. It cannot:
- Authorise financial decisions — you need an EPA
- Request voluntary assisted dying — separate legislation and process
- Compel doctors to provide treatment they deem futile
- Operate after death — funeral and estate decisions need a will
People who complete only an ACD and assume they've "taken care of everything" leave a significant gap. If they lose capacity, no one has authority to pay their bills, manage their property, or handle their financial affairs.
How to avoid it: Complete your ACD and an Enduring Power of Attorney at the same time.
Our South Australia Advance Directive & Living Will Kit is designed to prevent every one of these mistakes — with a signing-witnessing protocol that enforces the correct sequence, a witness verification checklist, clinically precise drafting examples for binding provisions, and a document distribution log to ensure your directive is actually accessible when it matters.
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