DNR in Western Australia: How to Refuse Resuscitation Legally

WA Does Not Have a Standalone DNR Form

If you search for a "Do Not Resuscitate form Western Australia," you will not find one — because WA does not use a standalone DNR document. Instead, the legal framework for refusing resuscitation and other life-sustaining treatment operates through two separate but related mechanisms:

1. Your Advance Health Directive (AHD) — a statutory document where you record binding treatment refusals in advance, including a refusal of CPR
2. The Goals of Patient Care (GOPC) form — a clinical order written by hospital doctors during a specific admission, which can include a "Not for CPR" designation

These two documents serve different functions, work at different times, and carry different legal weight. Understanding the distinction is critical if you want to ensure your refusal of resuscitation is respected.

Refusing CPR Through an Advance Health Directive

The AHD is the legal instrument. Under Part 9B of the Guardianship and Administration Act 1990, you can record a binding refusal of CPR that takes effect when you lose decision-making capacity and the clinical situation matches the scenario you described.

Part 4 of the AHD form — the mandatory treatment decisions section — provides structured options for life-sustaining treatment, including resuscitation. The strongest approach is to be specific about the clinical context:

• "I refuse CPR if I am diagnosed with a terminal illness with a prognosis of less than 12 months"
• "I refuse CPR if I am in a persistent vegetative state"
• "I refuse CPR if I have advanced dementia and cannot recognise my family"

A blanket "no CPR under any circumstances" may leave clinicians without the clinical context needed to apply the decision. A 60-year-old with no serious health conditions who has a sudden cardiac arrest on a tennis court presents a very different clinical picture from a 90-year-old with terminal cancer. The more specific your directive, the less room there is for clinical reading-down.

The GOPC: How Hospitals Document "Not for CPR"

When you are admitted to a WA public hospital, the treating team will typically initiate a Goals of Patient Care discussion. This is a clinical conversation — not a legal document — where the doctor establishes the "ceiling of care" for the current admission.

If the conversation concludes that CPR would be clinically futile or contrary to the patient's wishes, the doctor writes a GOPC order that may include:

• "Not for CPR"
• "Not for ICU admission"
• "For comfort measures only"
• "For active symptom management — no escalation"

The GOPC is what paramedics and emergency clinicians look at first during a cardiac arrest. It is immediately actionable because it is a medical order in the patient's chart, not a legal document that needs interpretation.

Important: A GOPC applies to the current admission or episode of care. When you are discharged and readmitted, a new GOPC discussion should happen. Your AHD, by contrast, persists across all future admissions until revoked, subject to its validity, scope, and the limited statutory exceptions.

How the AHD and GOPC Interact

The AHD sits above the GOPC in the legal hierarchy. For non-urgent treatment, if your AHD contains a clear refusal of CPR in a defined clinical context, the hospital should follow that refusal regardless of what the GOPC says or what the family wants, subject to the limited statutory exceptions.

In well-functioning hospitals, the GOPC process starts by checking for an AHD. If one exists, the AHD's treatment decisions form the foundation, and the GOPC fills in the clinical gaps for the current admission. If no AHD exists, the GOPC is built from scratch through conversation with the patient (if they have capacity) or their substitute decision-maker.

Your Right to Refuse Treatment in WA

The right to refuse medical treatment — including life-sustaining treatment — is well established in Western Australian law. Under the common law principle of informed consent, an adult with decision-making capacity can refuse treatment, and a health professional should not provide it contrary to that refusal.

An AHD extends this right into the future: it lets you refuse treatment now for scenarios that may arise later, when you can no longer communicate. The statutory framework under the Guardianship and Administration Act 1990 gives that refusal the force of law.

What the right to refuse does not include:

• Voluntary Assisted Dying (VAD). The Voluntary Assisted Dying Act 2019 requires you to maintain capacity throughout the process. You cannot use an AHD to request VAD, because the AHD only activates when you have lost capacity. These are legally incompatible frameworks.
• Demanding futile treatment. You can refuse CPR, but you cannot demand CPR when the medical team has determined it would be clinically futile (the body will not respond to resuscitation). AHD refusals remain subject to the statutory rules on validity and urgent treatment; the right to demand treatment is not unlimited.

Making Your Refusal Stick

Three practical steps:

1. Document it properly in Part 4 of the AHD. Specify the clinical scenarios. Use the structured options the statutory form provides. A GP consultation before completing this section ensures your decisions reflect realistic clinical outcomes.

2. Upload to My Health Record. Scan the signed AHD in black-and-white at 300 dpi and upload via myGov. This gives emergency departments another way to access your directive at 2 AM when your filing cabinet is across the city.

3. Carry an alert card. A wallet card noting that you have an AHD, where it is filed, and who your enduring guardian is can give the treating team an early signal to check My Health Record before defaulting to standard resuscitation protocols.

The Western Australia Advance Directive & Living Will Kit includes clinician-tested language for CPR refusal decisions, a GOPC preparation guide for hospital admissions, and a printable alert card — so your refusal is documented, accessible, and legally robust.

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