Advance Health Directive vs Enduring Power of Guardianship in WA
Three Documents, Three Completely Separate Jobs
Western Australia splits future planning into three statutory instruments under the Guardianship and Administration Act 1990, and each one covers a different category of decisions. Confusing them — or assuming one covers everything — is the single most common planning mistake in WA.
Here is the short version:
| Document | Controls | Financial authority? | Takes effect |
|---|---|---|---|
| Advance Health Directive (AHD) | Specific medical treatment decisions you record in advance | No | When you lose capacity AND the clinical situation matches your documented decisions |
| Enduring Power of Guardianship (EPG) | Personal, lifestyle, and medical decisions not covered by an AHD | No | When you lose capacity |
| Enduring Power of Attorney (EPA) | Financial affairs and property transactions | Yes | Immediately (if drafted that way) or upon loss of capacity |
The most dangerous confusion: assuming that an EPA — which gives someone authority over your finances — also lets them make medical decisions. It does not. An attorney under an EPA cannot consent to or refuse surgery on your behalf. That requires either a valid AHD or an appointed enduring guardian under an EPG.
How the Hierarchy Works in Practice
When you are admitted to a WA hospital and cannot make your own decisions, the medical team follows a legally mandated sequence:
Step 1: Check for a valid AHD. If you have one and it addresses the treatment question at hand, it governs subject to the limited statutory exceptions. Your AHD overrides everyone — family, guardian, doctor — when it is valid and applicable.
Step 2: Consult your enduring guardian (EPG). If no AHD exists, or if the AHD is silent on the specific treatment decision, the hospital looks for an appointed enduring guardian. That person can consent to or refuse treatment on your behalf, consistent with what they believe you would have wanted.
Step 3: Follow the statutory hierarchy. If no valid AHD applies and there is no enduring guardian with authority, the doctor must seek consent from the first available person on the statutory list: a guardian with authority, then a spouse or de facto partner, adult children, a parent, a sibling, a primary unpaid carer, or another person with a close personal relationship. The person must be at least 18, have full legal capacity, be reasonably available, and be willing to make the decision.
Your EPA-appointed attorney does not appear anywhere in this medical decision-making sequence. They handle the money side: paying hospital bills, managing your mortgage, selling property to fund care. Important, but different.
When You Need All Three
Most comprehensive estate plans in WA include all three documents, and here is why they need to work together:
Scenario: Your enduring guardian decides you need to move into residential aged care. The guardian has the authority to choose the facility and consent to the move. But the aged-care bond might be $300,000. Your guardian cannot access that money — they need your EPA-appointed attorney to release the funds from your savings or sell your house.
If these two appointees cannot cooperate, the administration of your care stalls. This is not hypothetical: the State Administrative Tribunal regularly hears cases where a spouse (appointed as guardian) and an adult child (appointed as attorney) are in conflict over care funding.
Scenario: You are admitted to hospital with a stroke. The AHD you completed three years ago refuses mechanical ventilation in the event of a persistent vegetative state. The treating team follows that instruction. Meanwhile, your enduring guardian consents to palliative care and arranges transfer to a hospice — a lifestyle decision the AHD does not cover. Your attorney under the EPA handles authorised financial arrangements for that care, subject to the EPA's scope and any applicable asset rules.
Three documents, three roles, all working in sequence.
Free Download
Get the Western Australia — Advance Directive Quick-Start
Everything in this article as a printable checklist — plus action plans and reference guides you can start using today.
Practical Advice: Who Gets Appointed Where
The cleanest structure is often:
- AHD: No appointment needed — you are recording your own treatment decisions directly
- EPG: Appoint someone who knows your personal values and can handle medical conversations under pressure (often a spouse, adult child, or close friend)
- EPA: Appoint someone with financial competence who can manage accounts, deal with Landgate ($225.10 registration fee for property transactions), and administer assets
These can be the same person, but they do not have to be — and sometimes separating the roles reduces the risk of one individual being overwhelmed. A spouse might be the right person to make care decisions but might struggle with complex financial administration, or vice versa.
The Documents You Already Have Might Not Be Enough
If you completed an EPA five years ago and assumed it covered everything, it almost certainly does not cover medical or personal decisions. If you moved from Victoria (which uses a single Advance Care Directive that can cover both treatment preferences and values) and assumed it would work in WA, the statutory frameworks are different enough that you should complete WA-specific forms.
The Western Australia Advance Directive & Living Will Kit covers both the AHD and EPG workflows in a single package, with clear guidance on how the three documents interact and a coordinator checklist to make sure nothing falls through the gaps.
Get Your Free Western Australia — Advance Directive Quick-Start
Download the Western Australia — Advance Directive Quick-Start — a printable guide with checklists, scripts, and action plans you can start using today.