How to Revoke or Update an Advance Health Directive in WA

Why Revocation Matters More Than Most People Realise

An Advance Health Directive (AHD) in Western Australia does not expire. Once validly executed, it remains legally binding until you revoke it. That permanence is both a strength and a risk — because your medical circumstances, personal values, and family relationships do change. An AHD written five years ago after a cancer scare might no longer reflect your wishes after successful treatment. A directive naming your spouse as a key contact might need updating after a separation.

The Guardianship and Administration Act 1990 provides clear mechanisms for revocation and replacement. Here is how they work.

How to Revoke an AHD

You can revoke your existing AHD at any time while you still have full legal capacity. If you want to change a signed AHD, revoke or cancel it and make a new one using the current prescribed form.

Method 1: Execute a new AHD. The simplest approach. When you complete and sign a new AHD that meets all statutory requirements (Parts 1, 4, and 6 completed; proper witnessing), use the revocation statement in the current form to indicate that you are revoking the earlier directive.

However, you should still physically retrieve or destroy copies of the old AHD. If a hospital finds two directives — an old one in your GP's records and a new one on My Health Record — and cannot determine which is current, the confusion can delay clinical decisions at exactly the wrong moment.

After revocation: notify everyone who holds a copy. The WA Department of Health recommends writing to everyone relevant — including your GP, other health professionals, healthcare providers, family members and friends who hold a copy — to tell them that you have revoked or cancelled the AHD. Ask them to return their old copies and destroy them.

A verbal change of mind may be difficult to establish in a crisis, so do not rely on a message to family or a doctor alone; use the current form's revocation mechanism and notify everyone who holds a copy.

The 10-Year Reading-Down Rule

WA's revocation framework has an unusual feature. Under the Guardianship and Administration Act 1990, a clinician can "read down" an AHD that was made more than ten years ago. This is not revocation — the directive remains legally in force — but it gives the treating doctor discretion to reconsider whether the directive still reflects the maker's intentions, taking into account:

• The maker's age when the directive was completed
• The elapsed time since execution
• Advances in medical treatment since the directive was written

In practice, this means a directive refusing cardiac intervention that was written in 2014 might be reconsidered in 2026 because modern cardiac surgery has significantly lower mortality rates. The doctor does not ignore the directive — they assess whether the clinical context has shifted enough that the maker might have decided differently with current information.

How to prevent reading down: Review your AHD every few years with your GP. A recent review can help show that the directive remains current and is one factor in a validity assessment; if you want to change it, revoke the signed directive and make a new one.

When to Update (Not Just Review)

A review confirms your existing directive still reflects your wishes. An update means completing a new AHD with changed treatment decisions. Key triggers for an update:

After a major diagnosis. A diagnosis of early-stage dementia, heart failure, or cancer changes the clinical scenarios your directive should address. Part 4 treatment decisions should reflect the realistic trajectory of your specific condition, not generic scenarios.

After a relationship change. If your directive references family members by name (common in the values section, Part 3), a separation, divorce, or death in the family may make those references outdated. If you have also changed your enduring guardian under an EPG, your AHD should be reviewed in parallel to ensure the documents are consistent.

After a hospital admission. If your existing AHD was tested during a hospital stay — meaning a doctor consulted it and made treatment decisions based on it — debrief with your GP. Was the directive clear enough? Did the clinical team act the way you intended? Were there decisions the directive did not address? This real-world feedback is invaluable for strengthening the next version.

After significant changes in medical technology. New treatments for conditions like heart failure, stroke, and cancer can shift the risk-benefit calculation underlying your treatment decisions. What was clinically futile five years ago may now be a viable intervention, or vice versa.

The Practical Steps

1. Complete a new AHD following the same process as the original: download the current form from HealthyWA, consult your GP about Part 4, complete mandatory sections, cross out unused optional sections, and sign with two witnesses (at least one authorised under the OASD Act 2005).

2. Destroy or clearly mark old copies. Retrieve copies from your GP, family members, and any aged-care facility. Either shred them or clearly mark them "SUPERSEDED" with the date of the new directive. Ask your GP to replace the old copy in your medical record.

3. Update My Health Record. Log in to myGov, remove the old AHD upload, and upload the new one (black-and-white scan, 300 dpi, under 20 MB).

4. Notify your enduring guardian. If you have an EPG, provide your guardian with a copy of the new AHD so they understand the updated scope of decisions already covered — and where their authority begins.

The Risk of Not Updating

An outdated AHD does not just sit harmlessly in your files. It may still be treated as operative unless it has been revoked or a validity issue applies. If your medical circumstances have changed but the directive has not, the clinical team could make treatment decisions based on preferences you no longer hold.

The Western Australia Advance Directive & Living Will Kit includes a review schedule template, a revocation checklist, and an update walkthrough — so you can keep your directive current without restarting the entire process from scratch.

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