End of Life Planning Victoria
Why Victoria's End of Life Framework Demands a Proper Plan
Victoria's Medical Treatment Planning and Decisions Act 2016 gives you stronger control over your end of life medical care than almost any other jurisdiction in Australia. An instructional directive written into a valid Advance Care Directive (ACD) is legally binding on every treating clinician — they must follow it as though you were giving consent directly.
That legal strength comes with a catch: if you haven't completed the documents correctly, you lose the protections entirely. Without a valid ACD, a clinical team falls back on the statutory hierarchy of decision-makers, starting with your spouse or domestic partner and working down through unpaid carers, adult children, parents, and siblings. That default order may not match your actual wishes.
The Four Documents That Make Up a Complete Victorian Plan
End of life planning in Victoria involves four distinct instruments, and each has a different legal function:
1. Advance Care Directive (ACD) — Your written treatment preferences, which can include both values directives (general goals for your care) and instructional directives (specific refusals or consents, like refusing CPR or accepting organ donation). Instructional directives are binding on clinicians.
2. Medical Treatment Decision Maker (MTDM) appointment — Names the person who will make medical decisions if you lose capacity. Only one MTDM can act at any time. This is separate from a power of attorney.
3. Enduring Power of Attorney (EPOA) — Covers financial and personal/lifestyle decisions only. An EPOA attorney cannot make medical treatment decisions in Victoria — that's a common and dangerous misunderstanding.
4. Your Will — Takes over at death. Everything above ceases to have legal effect the moment you die, and your executor steps in.
Patient Rights at End of Life in Victoria
Victorian law is unambiguous on several patient rights that many families don't realise they have:
Right to refuse any medical treatment. A competent adult can refuse treatment even if that refusal will result in death. This right is absolute and cannot be overridden by a clinician or family member.
Right to binding directives. An instructional directive in a valid ACD carries the same legal force as a direct contemporaneous refusal — clinicians who ignore it face professional and legal consequences.
Right to palliative care. Every Victorian has a right to access palliative care services regardless of whether they refuse curative treatment.
Right to a decision-maker of your choosing. You can appoint anyone 18 or over as your MTDM, provided they accept the role. If you don't appoint someone, the statutory hierarchy decides.
Right to revoke at any time. You can revoke or change your ACD at any time while you still have decision-making capacity, either by completing a new directive or by destroying the original.
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Get the Victoria — Advance Directive Quick-Start
Everything in this article as a printable checklist — plus action plans and reference guides you can start using today.
Step-by-Step: Building Your End of Life Plan
Step 1 — Identify your values and treatment preferences. Before downloading any forms, spend time thinking through what matters to you: being able to recognise family, remaining at home, avoiding permanent ventilator dependence, or prioritising comfort over life extension.
Step 2 — Book a GP conversation. Your GP is the single most important appointment in this process, because a registered medical practitioner must witness your ACD. Use this appointment to translate your values into precise clinical language — vague phrasing like "no heroic measures" can be difficult for emergency teams to interpret. Expect fees of $100 to $300 for this witnessing service, which is not covered by Medicare.
Step 3 — Complete and sign your ACD and MTDM forms. Download the statutory forms from the Victorian Department of Health website (they're free). The ACD requires two adult witnesses, one of whom must be a registered medical practitioner, and both must be physically present — remote witnessing via video link is prohibited.
Step 4 — Distribute certified copies. Victoria has no centralised directive registry. You need to provide copies to your GP, any treating specialists, your local hospital's records department, and your MTDM. Upload a copy to your federal My Health Record for emergency access.
Step 5 — Review every two years. An outdated, unreviewed ACD may be interpreted as a values directive rather than a binding instructional one. Major health changes — a new diagnosis, hospitalisation, or a move to residential care — should trigger an immediate review.
Common Mistakes That Invalidate Your Plan
Three errors account for the majority of invalid Victorian ACDs:
Using an EPOA attorney for medical decisions. This is legally impossible in Victoria. If you haven't appointed an MTDM separately, your EPOA attorney has zero authority over your healthcare.
Signing without a doctor present. Both witnesses must sign at the same time, in person. A directive witnessed by two lay adults, even if one is a lawyer, is invalid.
Non-clinical language in instructional directives. "No extraordinary measures" means different things to different clinicians. Phrases like "I refuse cardiopulmonary resuscitation (CPR)" or "I refuse mechanical ventilation if there is no reasonable prospect of independent breathing" translate directly into hospital Goals of Patient Care orders.
Putting It All Together
A complete end of life plan in Victoria isn't a single document — it's a coordinated set of legal instruments, distributed to the right people, reviewed regularly, and written in language that clinical teams can act on without hesitation. The Victoria Advance Directive & Living Will Kit walks you through every step, from the initial values conversation through the GP witnessing appointment and My Health Record upload, with clinician-approved phrasing templates for the directives themselves.
Get Your Free Victoria — Advance Directive Quick-Start
Download the Victoria — Advance Directive Quick-Start — a printable guide with checklists, scripts, and action plans you can start using today.