Advance Care Planning Northern Territory: The Complete Process

What Advance Care Planning Looks Like in the NT

Advance care planning in the Northern Territory is not just filling out a form. It is a process that starts with thinking through your values, moves through a legal document, and ends with making sure the right people can access that document when you cannot speak for yourself.

The NT system is distinctive because of two laws: the Advance Personal Planning Act 2013, which created the Advance Personal Plan as the single instrument for future planning, and the Health Care Decision Making Act 2023, which established how healthcare decisions are made when someone loses capacity.

Together, these create a framework that is more integrated than any other Australian state's approach — but that integration also means there are more steps to get right.

Step 1: Clarify Your Values and Wishes

Before you touch a form, spend time considering what matters to you about medical treatment and end-of-life care. The questions that matter most clinically:

• If you had a condition with no prospect of recovery, would you want life-sustaining treatment continued?
• Under what circumstances would you refuse CPR, mechanical ventilation, or artificial nutrition?
• How do you weigh quantity of life against quality of life?
• Are there religious, cultural, or personal beliefs that should guide treatment decisions?
• Where would you prefer to receive care — hospital, home, aged care facility, on Country?

These are not hypothetical exercises. When a crisis hits at Royal Darwin Hospital or Alice Springs Hospital, the treating team needs answers to exactly these questions. The clearer you are now, the more likely your wishes will be followed.

Step 2: Choose Your Decision-Makers

The Advance Personal Plan lets you appoint one or more decision-makers across three areas: financial, lifestyle, and healthcare. You can appoint the same person for all three, or split authority among different people.

Choosing a healthcare decision-maker is the most consequential decision in the planning process. This person will be making treatment calls when you cannot. They need to understand your values, be available at short notice (particularly relevant in the NT, where your decision-maker might be interstate), and be willing to advocate firmly with medical staff.

Under the 2023 Act's hierarchy, if you have not appointed a healthcare decision-maker and no applicable Advance Consent Decision covers the treatment, the decision falls first to an NTCAT-appointed guardian with healthcare authority, then a relative recognised under Aboriginal or other customary law or tradition, then a spouse or de facto partner, then a non-commercial carer, then an adult child, parent, sibling, or close friend in that order, each with a close and continuing relationship, and finally the Public Guardian. If you want someone other than your next family member in that hierarchy to make decisions — a close friend, a specific sibling — you must appoint them in an APP.

Step 3: Draft and Execute the Advance Personal Plan

The APP form has three sections:

Advance Care Statement — record your general values, views, and preferences. This guides decision-makers but is not legally binding on clinicians.

Advance Consent Decision — record specific binding refusals or consents. If you refuse blood transfusions or mechanical ventilation under specified circumstances, that refusal is legally enforceable.

Decision-Maker Appointment — nominate your chosen people and specify the scope of their authority.

You do not have to complete all three sections. If you only want to record your healthcare wishes without appointing anyone, that is valid. If you only want to appoint a financial decision-maker, that works too.

The document must be signed in the physical presence of an authorised witness. NT law does not accept electronic signatures for APPs. Authorised witnesses include justices of the peace, legal practitioners, medical practitioners, nurses, pharmacists, police officers, and social workers.

Step 4: Register and Distribute

Public Guardian and Trustee — free registration, strongly recommended. Post the original signed plan to the Darwin office. They scan, register, and return it within two to four weeks.

Land Titles Office — mandatory registration ($181) if the APP grants authority over real property.

My Health Record — upload a scanned PDF through the MyGov portal. This is critical for hospital access during emergencies.

Your GP — deliver a certified copy to your primary doctor and to the registry of your local hospital.

Your decision-makers — each appointed person should have their own copy and know where the original is stored.

The Aged Care Dimension

If you or a parent is entering residential aged care in the NT, the facility's staff will ask about advance care planning during admission. Having a current APP means the facility can reference your documented wishes for day-to-day care decisions and know exactly who to contact for treatment consent.

Without an APP, the facility relies on the statutory hierarchy, which can create confusion when multiple family members disagree about treatment.

What Our Kit Covers

The Northern Territory Advance Directive & Living Will Kit walks through this entire process with checklists for each step, a decision-maker worksheet, clinical translation tools for Goals of Care conversations, and the split-document strategy that keeps your medical wishes private from bank compliance teams.

See more Northern Territory guides →