Advance Health Directive Mistakes to Avoid in WA

The Mistakes That Turn a Binding Directive Into Waste Paper

Completing an Advance Health Directive (AHD) in Western Australia feels like a one-and-done task. Fill in the form, sign it, file it away. The problem is that the Guardianship and Administration Act 1990 sets exacting requirements for validity, and the WA Department of Health and Office of the Public Advocate consistently flag the same errors causing directives to fail when families need them most.

Here are the mistakes — and how to avoid each one.

Mistake 1: Using a Retired Professional as the Authorised Witness

Both witnesses must be independent adults, and at least one must be authorised to witness statutory declarations under the Oaths, Affidavits and Statutory Declarations Act 2005. The most common qualifying categories: currently registered doctors, pharmacists, lawyers, JPs, nurses, and police officers.

The trap is the word "currently." A retired GP who witnessed hundreds of statutory documents during their career loses that authority the moment they let their AHPRA registration lapse. A retired lawyer without a current practising certificate is equally disqualified.

This error is invisible at signing — nobody checks. It surfaces months or years later when a hospital legal team, family member, or the State Administrative Tribunal examines the document and discovers the authorised witness was not actually authorised.

Fix: Before signing, ask the witness to confirm their current registration or appointment. For health professionals, search the AHPRA public register. For lawyers, check the Legal Practice Board of WA.

Mistake 2: Leaving Optional Sections Blank Without Crossing Them Out

The AHD form has mandatory sections (Parts 1, 4, and 6) and optional sections (Parts 2, 3, and 5). If you choose not to complete an optional section, you must physically cross it out with a line or write "Not completed" across it.

The reason is tamper prevention. A blank section with no crossing-out could be interpreted as one that the maker intended to fill in later, or one that someone else could complete without authorisation. In a dispute, this ambiguity is enough to challenge the directive's validity.

Fix: Go through every page. If you are not completing a section, draw a single diagonal line through it or write "Intentionally left blank" and initial it.

Mistake 3: Writing Vague Treatment Decisions in Part 4

Part 4 requires at least one binding treatment decision. The most common mistake is writing something like:

• "No extraordinary measures"
• "Keep me comfortable"
• "No artificial prolonging of life"
• "Use common sense"

These phrases feel meaningful to the person writing them. They are clinically useless. A doctor reading "no extraordinary measures" at 3 AM in an emergency department does not know whether you are refusing CPR, ventilation, antibiotics, blood transfusions, or all of them.

The statutory form offers structured options precisely because freeform language fails. The stronger approach is to address each intervention specifically: "I refuse CPR if I am in a persistent vegetative state." "I consent to palliative sedation for pain management even if it may shorten my life." "I refuse mechanical ventilation in the context of terminal illness."

Fix: Complete Part 4 in consultation with your GP. Walk through each treatment option the form offers and make a concrete decision about each one in defined clinical scenarios.

Mistake 4: Both Witnesses Not Present Simultaneously

The Act requires both witnesses to be present at the same time when you sign. One witness in the morning and one in the afternoon does not count, even if both are properly qualified. They must both observe you signing the document in the same room at the same moment.

This trips up people in regional areas where they might visit the GP in the morning and the JP in the afternoon. Both visits are necessary, but the signing must happen with both present.

Fix: Coordinate a single signing appointment. A GP clinic is often the simplest venue — the doctor serves as the authorised witness and a practice nurse or receptionist serves as the second witness.

Mistake 5: Failing to Distribute or Upload the Completed Directive

A technically perfect AHD locked in a safe deposit box is functionally worthless during a medical emergency. If the treating team cannot find it, they follow the statutory hierarchy of treatment decision-makers for non-urgent treatment and make their own clinical judgment.

WA does not have a centralised register for AHDs. My Health Record is a recommended digital distribution mechanism — it is voluntary, and many people do not use it because the upload process is not straightforward.

Fix: After signing, take four actions: (1) give a certified copy to your GP and ask them to note it in your medical record, (2) give copies to your enduring guardian and close family, (3) upload a scanned copy (black-and-white, 300 dpi, under 20 MB) to My Health Record via myGov, and (4) carry an Advance Health Directive alert card in your wallet noting that a directive exists and where to find it.

Mistake 6: Using an Interstate or Overseas Template

Each Australian state has its own advance care planning framework with different form requirements, witnessing rules, and legal effects. A Queensland AHD requires only one witness. A Victorian Advance Care Directive uses a different statutory framework entirely. An American living-will template has no legal force in WA.

The WA Department of Health strongly advises using the statutory form published on HealthyWA. Modified forms — including versions published by advocacy groups — carry a higher risk of validity challenges.

Fix: Download the current form from HealthyWA (healthywa.wa.gov.au). If you moved to WA from another state, complete a new WA-specific form rather than relying on your existing interstate document.

Mistake 7: Not Reviewing the Directive After a Major Life Change

An AHD does not expire, but the 10-year "reading down" provision means clinicians can reconsider an old directive if medical advances have changed the treatment landscape. Beyond the legal test, a directive written before a significant diagnosis, a change in family structure, or a shift in personal values may not reflect your current wishes.

Fix: Review your AHD every two to three years, and always after a major diagnosis, marriage, separation, or the birth of grandchildren. A brief GP review can help show that the directive remains current; if you want to change it, revoke the signed directive and make a new one.

The Common Thread

Every one of these mistakes is preventable, and every one is invisible at the time of signing. The AHD looks valid on paper. The error only surfaces when someone challenges it — in a hospital ward, at the SAT, or during a family dispute — at exactly the moment when it matters most.

The Western Australia Advance Directive & Living Will Kit includes a pre-signing compliance checklist, annotated form guidance for every section, and a witnessing verification tool — designed specifically to catch these errors before the document is finalised.

See more Western Australia guides →