Advance Health Directive WA: How to Make One in Western Australia

What an Advance Health Directive Actually Does in WA

An Advance Health Directive (AHD) is a statutory document under Part 9B of the Guardianship and Administration Act 1990 that lets you record binding decisions about future medical treatment — decisions that take effect only if you lose the capacity to speak for yourself.

The critical word is "binding." In Western Australia, a valid AHD sits at the absolute top of the statutory hierarchy of treatment decision-makers. That means it overrides your family, your GP, and even an appointed Enduring Guardian. If you have documented a clear refusal of ventilation, for instance, the treating team must follow that instruction. They can depart only under the limited exceptions recognised by WA law, including changed circumstances that could not reasonably have been anticipated and would likely have changed the decision, or urgent treatment where it is not practicable to determine whether an AHD exists or obtain a hierarchy decision (more on that below).

This hierarchy matters because many people assume their spouse or children will automatically make these calls. Without an AHD, that is often true — the Guardianship and Administration Act 1990 prescribes a ranked list of people who get asked in turn. But the list might not match your preferences: the statutory sequence includes an enduring guardian or guardian with authority, spouse or de facto partner, adult children, parents, siblings, a primary unpaid carer, and another person with a close personal relationship, subject to age, capacity, availability, and willingness requirements.

The Three Mandatory Parts of the AHD Form

The WA Department of Health publishes a prescribed AHD form — available free from HealthyWA — but the form itself is dense. Here is what the law requires for validity:

Part 1 — Personal Details. Your full legal name, date of birth, and contact information. Complete these carefully so the directive can be identified at hospital intake.

Part 4 — Treatment Decisions. This is where most people stall. You must record at least one binding treatment decision. The form offers structured options for life-sustaining treatment, pain management, and specific clinical interventions. Vague statements like "no heroic measures" are clinically useless — medical staff need specifics. The stronger approach: decide whether you consent to or refuse CPR, mechanical ventilation, artificial nutrition/hydration, and dialysis in defined clinical scenarios (such as terminal illness, persistent vegetative state, or advanced dementia).

Part 6 — Witnessing and Signatures. You sign in front of two independent adult witnesses. At least one must be authorised to witness statutory declarations under the Oaths, Affidavits and Statutory Declarations Act 2005 — that includes currently registered medical practitioners (including GPs), pharmacists, lawyers, JPs, police officers, and several other categories. Both witnesses must be present simultaneously. An interpreter or translator who helped complete the form cannot be a witness.

Optional sections (Parts 2, 3, 5) are exactly that — optional. But here is the trap: if you skip them, you must physically cross out each unused section. Leaving a section blank without crossing it out creates ambiguity, and a hospital legal team may question whether someone else intended to fill it in later.

Step-by-Step: Completing Your AHD

1. Download the current form from HealthyWA (healthywa.wa.gov.au). Do not use interstate forms — NSW, Victoria, and Queensland have completely different legislative frameworks.

2. Book a GP consultation before filling in Part 4. Your doctor can walk you through the clinical implications of each treatment option. This is not a legal requirement, but it can help you make the directive clinically clear.

3. Complete Parts 1, 4, and 6. Cross out every optional section you are not using. Write in clear, clinical language — "I refuse mechanical ventilation if I am in a persistent vegetative state" rather than "I do not want to be kept alive artificially."

4. Arrange your witnesses. You need two adults present at the same time. At least one must be on the authorised-witness list. Your local pharmacy, GP clinic, or JP signing centre at the courthouse can usually help. A common mistake: using a retired professional. Once a doctor, pharmacist, or lawyer stops actively practising, they lose their authorised-witness status.

5. Distribute copies. Give a certified copy to your GP and ask them to upload it to your local medical record. Provide copies to any appointed Enduring Guardian and to close family members who might be contacted in an emergency.

6. Upload to My Health Record. Scan the signed document in black-and-white at 300 dpi (this keeps the file under the 20 MB upload limit). Log in through myGov, navigate to your My Health Record, and upload under "Advance Care Planning." This step is not legally required, but it can make your directive available to treating healthcare professionals who access My Health Record — critical if you are transferred interstate or admitted through emergency.

The 10-Year "Reading Down" Rule

An AHD in Western Australia does not expire — it remains legally binding until you revoke it. However, the Guardianship and Administration Act 1990 gives clinicians the power to "read down" a directive that is more than ten years old. In practice, this means a doctor can argue that medical advances have changed the clinical landscape so significantly that the maker could not have anticipated current treatment options.

This does not mean your AHD is worthless after a decade. It means you should review it every few years, particularly after a major diagnosis or a significant change in your personal circumstances. A review can help show that an AHD remains current; if you want to change a signed AHD, revoke it and make a new one.

What an AHD Cannot Do

Two important boundaries:

It cannot demand treatment a doctor considers clinically futile. You can refuse treatments, but you cannot compel a medical team to provide CPR or ventilation when they judge it would cause suffering without meaningful benefit.

It cannot authorise Voluntary Assisted Dying (VAD). The Voluntary Assisted Dying Act 2019 requires the patient to maintain decision-making capacity throughout the entire VAD process. An AHD, by definition, only activates when you have lost capacity. These two frameworks are legally incompatible.

Getting It Right the First Time

The difference between an AHD that works in a crisis and one that gets shelved is specificity. Hospitals act on clear clinical instructions. They hesitate on vague wishes. A GP consultation before you fill in Part 4, combined with proper witnessing and digital upload, covers the three failure points that invalidate most self-completed directives in WA.

The Western Australia Advance Directive & Living Will Kit walks you through every section of the statutory form with annotated examples, a witnessing compliance checklist, and a step-by-step My Health Record upload guide — the practical bridge between the government's free forms and a $600+ elder-law appointment.

See more Western Australia guides →