How to Complete an Advance Care Directive in Victoria Without a Lawyer
You do not need a lawyer to complete a legally binding advance care directive in Victoria. The Medical Treatment Planning and Decisions Act 2016 sets no requirement for legal drafting, legal review, or solicitor involvement. A directive is valid if the principal has decision-making capacity, the document is in writing and signed, and two witnesses — one of whom must be a registered medical practitioner — are physically present when the principal signs. Thousands of Victorians complete valid directives without legal assistance every year.
The practical challenge is not the law. It is the gap between the free statutory forms published on Health.vic and the clinical precision that hospital teams need to follow your directive in an emergency. The forms are blank. They give you a signature line and an instructional directive section with no guidance on what to write, how to phrase it, or how to get a GP to witness it. Filling that gap is the actual work — and it does not require a law degree.
The Five Steps to a Complete Directive
Step 1: Clarify Your Treatment Preferences
Before you write anything, you need to decide — specifically — which medical treatments you want refused, which you want continued, and under what clinical circumstances. Vague wishes ("no heroic measures," "let nature take its course") are not clinically actionable. Emergency departments work from internal clinical orders — Goals of Patient Care summaries and Acute Resuscitation Plans — and they need directive language that translates directly into those orders.
Treatment decisions to consider:
- Cardiopulmonary resuscitation (CPR) — in what circumstances? All? Only if reversible? Never?
- Mechanical ventilation — temporary for a recoverable condition? Permanent? Neither?
- Artificial nutrition and hydration — tube feeding, IV fluids, when and for how long?
- Dialysis — if kidneys fail during a terminal illness?
- Antibiotics — in end-stage illness? For comfort only?
- Blood transfusions — all? Conditional? None?
- Organ donation — yes, no, with restrictions?
- Palliative sedation — at what point? Under what conditions?
The instructional directive section of your ACD is where these decisions go. The phrasing matters: "I refuse cardiopulmonary resuscitation and mechanical ventilation in the setting of irreversible multi-organ failure" gets followed. "I don't want extraordinary treatment" gets debated at the bedside.
Step 2: Appoint Your Medical Treatment Decision Maker
In Victoria, an Enduring Power of Attorney does not cover medical decisions. The EPOA under the Powers of Attorney Act 2014 handles financial and personal matters. The term "Medical Power of Attorney" has been legally obsolete since 12 March 2018. To give someone authority over your healthcare decisions when you cannot make them yourself, you must appoint a Medical Treatment Decision Maker under the 2016 Act.
Your MTDM should be someone who:
- Understands your treatment preferences and can articulate them under pressure
- Is willing to enforce your directive against family members who disagree
- Is geographically available — they may need to be at the hospital within hours
- Is not easily overridden by clinicians or extended family in a crisis
The MTDM appointment is a separate document, but it should be completed at the same time as your ACD. A registered medical practitioner can witness both. For the MTDM, the authorised witness may instead be a solicitor or Justice of the Peace, and unlike the ACD the appointment may be witnessed by audio-visual link.
Step 3: Draft the Values Directive
Beyond specific treatment instructions, a values directive captures the quality-of-life considerations that guide decisions in scenarios your instructional directive does not explicitly cover. This is where you document:
- What "quality of life" means to you — independence, cognitive function, ability to communicate, spiritual practice
- Pain management preferences — maximum comfort vs. maximum alertness
- Religious or cultural considerations that affect treatment decisions
- Circumstances under which you would or would not want life-sustaining treatment continued
- Your position on experimental treatments, clinical trials, and palliative care timing
A well-drafted values directive gives your MTDM the context to make decisions you did not anticipate. Without it, they are guessing — and under the stress of an ICU admission, guessing leads to family conflict and clinical delays.
Step 4: Get It Witnessed
This is the step that blocks more families than any other. The 2016 Act requires:
- Two adult witnesses, both physically present in the same room when you sign
- One witness must be a registered medical practitioner (GP, specialist, hospital doctor)
- Neither witness can be your appointed MTDM
- No remote witnessing — no video calls, no audio-visual link, no exceptions
GPs routinely decline witnessing requests. Common reasons: unfamiliarity with the 2016 Act, liability concerns, time constraints during standard consultations. Those who agree typically charge $100 to $300 for a non-Medicare-rebatable administrative appointment.
How to secure the appointment:
Frame it as a clinical conversation, not a legal chore. Call the clinic and explain you need a double-length appointment for an advance care directive witnessing. Mention you have the directive pre-drafted and the clinical phrasing completed — the GP's role is capacity certification and witnessing, not drafting.
Bring everything pre-prepared. The GP should see a completed directive with specific treatment instructions, a drafted MTDM appointment form, and any relevant medical history. Walking in with blank forms guarantees the appointment will overrun or get deferred.
Bring your second witness. The GP provides one witness; you need to arrange the other. This can be any adult who is not your appointed MTDM — a friend, a neighbour, a family member who is not the appointee.
Expect the capacity assessment. The GP must certify that you understand the nature and effect of the directive and the treatment decisions it documents. This is a functional assessment, not a cognitive test. If you can explain what you are signing and why, you will pass.
Step 5: Distribute and Store
A directive that no one can find in an emergency is functionally identical to not having one. After signing:
- Upload to My Health Record via myGov — emergency departments can access it electronically
- Give copies to your MTDM, your GP, and any specialist you see regularly
- If entering residential aged care, provide a copy to the facility's clinical team
- Store the original in a known, accessible location — not a safe deposit box that requires a key and a trip to the bank during a cardiac arrest at 3 a.m.
- Tell your family where the original is stored and who has copies
Common Mistakes That Invalidate the Directive
- Remote witnessing. Signing via video call with a GP is not valid under the 2016 Act. Both witnesses must be physically present.
- MTDM as witness. Your appointed Medical Treatment Decision Maker cannot serve as one of the two witnesses.
- Vague instructional language. "No heroic measures" is not an instruction. It is an aspiration. Specify the treatments by name.
- Using pre-2018 forms. A Medical Power of Attorney form used today will not create a valid new appointment — documents executed after 12 March 2018 must use the statutory MTDM form. (Existing pre-commencement medical enduring powers generally continue to operate.)
- Assuming EPOA covers medical decisions. It does not. An EPOA and an MTDM are separate appointments under separate statutes.
Who This Approach Is For
- Adults in Victoria who want a legally binding advance care directive without paying $800–$2,500 for a solicitor-drafted package
- Adult children helping a parent complete advance care planning — especially before cognitive decline narrows the capacity window
- De facto and same-sex partners who need formal MTDM appointments to secure decision-making authority that the statutory hierarchy otherwise requires them to prove during a crisis
- People who downloaded the free forms from Health.vic, saw the blank instructional directive section, and stopped
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Who This Approach Is NOT For
- People with complex estates involving testamentary trusts, cross-jurisdictional assets, or contested family structures — a solicitor provides tailored coordination between the ACD, EPOA, and estate plan
- Families with active disputes about a parent's care or the identity of the MTDM — solicitor involvement protects the directive from legal challenge
- Anyone whose family member has already lost decision-making capacity — the directive window has closed; medical decisions then follow the statutory hierarchy, and a VCAT guardianship application is needed only if no one on that list is available or the family is in dispute
Tradeoffs of the DIY Approach
Advantages: immediate — you can complete the directive today. Legally identical to a solicitor-drafted document. Lower cost. You retain full control over the process and the phrasing.
Limitations: no tailored legal advice for complex estates. No solicitor's file note as evidence of capacity (though the GP's witnessing certification serves a similar evidentiary function). No representation if the directive is challenged at VCAT.
Frequently Asked Questions
Is a DIY advance care directive as legally strong as one drafted by a solicitor?
Yes. The Medical Treatment Planning and Decisions Act 2016 makes no distinction based on who drafted the directive. A valid directive requires capacity, a written and signed document, and proper witnessing. The legal strength comes from the statutory requirements being met, not from the drafter's qualifications.
How much does it cost to complete a directive without a lawyer?
The government forms are free. A GP witnessing appointment typically costs $100 to $300 (non-Medicare-rebatable). A structured planning kit like the Victoria Advance Directive & Living Will Kit costs . Total: under $350 compared to $800–$2,500 for a solicitor-drafted package.
What if my GP refuses to witness?
Try another GP, a geriatrician, or a hospital-based doctor. The Act requires a "registered medical practitioner" — it does not have to be your regular GP. Some community health centres and hospital-based advance care planning clinics offer witnessing services. The key is arriving with a pre-drafted directive so the appointment focuses on capacity assessment and witnessing, not drafting.
Can I update my directive later?
Yes. You can revoke or amend your ACD at any time while you have decision-making capacity. A new directive supersedes the old one. The revocation must be communicated to anyone who holds a copy — your MTDM, your GP, your aged care facility, and My Health Record.
Do I need to complete an EPOA at the same time?
Not legally, but practically it makes sense. Your ACD and MTDM cover medical decisions; your EPOA covers financial and personal matters. Completing them at the same time reduces the logistical burden. An EPOA cannot rely on a GP as its authorised witness — one EPOA witness must be a Justice of the Peace, a bail justice, or a lawyer.
The Victoria Advance Directive & Living Will Kit provides the structure that the free forms lack — clinical phrasing templates, the GP witnessing protocol, MTDM appointment with interview script, and the complete workflow from blank page to signed, distributed, digitally uploaded directive. One afternoon, no solicitor.
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