Advance Health Directive QLD: What It Is and How to Complete One

What Is an Advance Health Directive in Queensland?

An Advance Health Directive (AHD) is a legal document that lets you record binding instructions about your future medical treatment — instructions that take effect if you lose the capacity to make decisions yourself. In Queensland, the AHD is governed by the Powers of Attorney Act 1998 and is documented on the statutory Form 4 (currently Version 5).

Unlike a general "living will" or a values statement, the Queensland AHD carries real legal force. Healthcare providers are legally obligated to follow the treatment directions it contains, provided the document was validly executed and the clinical circumstances match what you specified. This makes the AHD fundamentally different from a Statement of Choices (Form A or Form B), which records your values and preferences but is not legally binding.

Queensland's system is also distinctive because the AHD can do double duty — it lets you both record specific treatment instructions and appoint an attorney for health matters. Most other Australian states split these functions across separate documents.

What an AHD Can and Cannot Do

The AHD is powerful, but it operates within defined boundaries.

It can:

• Consent to or refuse specific medical treatments (CPR, mechanical ventilation, artificial nutrition)
• Appoint an attorney to make health decisions on your behalf
• Set conditions or limitations on those appointments
• Override decisions made by an attorney or Statutory Health Attorney when it contains specific, relevant directions

It cannot:

• Request anything illegal, including Voluntary Assisted Dying (VAD requires cognitive capacity at every stage)
• Appoint someone for financial matters (you need an Enduring Power of Attorney for that)
• Replace an Acute Resuscitation Plan authorised by your treating doctor — an ARP is a separate medical order that operates alongside your AHD
• Cover every conceivable medical scenario — situations not addressed in the AHD fall to the applicable substitute decision-maker, such as an appointed attorney or Statutory Health Attorney

One critical limitation catches many people off guard: a direction to withhold or withdraw life-sustaining treatment can operate only if one of four statutory conditions applies: a terminal illness with no reasonable prospect of recovery where the treating doctor and another doctor agree that death is expected within one year; a persistent vegetative state with no reasonable prospect of cognitive recovery; a permanent coma with no reasonable prospect of regaining consciousness; or an illness or injury of such severity that the person will permanently require life-sustaining treatment to survive.

How to Complete Your AHD (Form 4)

Completing the AHD involves a strict sequence that must be followed precisely — documents signed out of order risk being declared invalid.

Step 1 — Registered medical practitioner consultation. Book an appointment with a registered medical practitioner specifically to discuss the AHD. They need to explain the clinical reality of treatments like CPR, ventilation, and tube feeding, then complete the capacity certificate in Section 5 of the form. This step must happen before you sign the document in front of a witness.

Step 2 — Draft your directions. Use precise, specific language. "No extraordinary measures" is too vague and gives clinicians room to default to active treatment. Instead, specify exactly which treatments you consent to or refuse, and under which of the four statutory conditions those directions apply.

Step 3 — Sign in front of an eligible witness. Your witness must be a Justice of the Peace, Commissioner for Declarations, Australian-qualified lawyer, or notary public. The witness performs a brief capacity assessment — asking open-ended questions to confirm you understand what you're signing — then completes the witness certificate. Sign as soon as possible after the doctor's assessment to avoid capacity fluctuation issues.

Step 4 — Attorney acceptance. If your AHD appoints an attorney for health decisions, they must sign the acceptance section (Section 8) before they can act on your behalf. They cannot witness your signature.

Step 5 — Distribute copies. Send copies to your GP, local hospital, appointed attorneys, and the Statewide Office of Advance Care Planning (via email to [email protected] or post to PO Box 2274, Runcorn QLD 4113). This ensures your AHD is uploaded to your electronic hospital record on "The Viewer," where clinicians and paramedics can access it during an emergency.

Common Mistakes That Invalidate an AHD

The most frequent errors are technical, not substantive:

• Wrong signing order. The doctor must sign the capacity certificate before you present the form to a witness. Reversing this sequence can invalidate the entire document.
• Ineligible witness. Your witness cannot be a relative of you or your appointed attorney, a beneficiary under your will, your paid carer, or your treating healthcare provider.
• Vague treatment directions. Ambiguous language gives doctors a legal basis to override your directive and default to active treatment — the so-called "ambiguity loophole."
• Not distributing copies. An AHD locked in a safe at home is worthless in an ambulance emergency. Clinical teams can only follow directions they can access.

How the AHD Interacts With Other Documents

Queensland's planning framework involves several documents that work together but occupy different legal positions:

• AHD (Form 4): Binding treatment directions when valid and applicable. Takes statutory priority over conflicting attorney directions for the matters it addresses.
• Enduring Power of Attorney (Form 2 or 3): Appoints decision-makers for financial, personal, and health matters. Your attorney's health decisions are overridden by any conflicting AHD directions.
• Statement of Choices (Form A/B): Advisory document recording your values and quality-of-life preferences. Not legally binding, but influential in guiding clinical decisions.
• Acute Resuscitation Plan (ARP): A medical order completed by your treating doctor that directs emergency teams on resuscitation. Operates alongside your AHD.

The hierarchy matters: if your AHD says "no CPR under the specified conditions" but your attorney asks the hospital to resuscitate you, a valid and applicable AHD direction takes priority. Your attorney can decide only about health matters the AHD does not cover.

Get Your Queensland Advance Directive Right the First Time

Getting the execution sequence wrong or using vague clinical language are the two fastest ways to undermine your AHD. Our Queensland Advance Directive & Living Will Kit walks you through every section of Form 4 with specific clinical phrasing guides, a signing protocol checklist, and a witness eligibility verification tool — so your document holds up when it matters most.

See more Queensland guides →