Advance Health Care Plan

An Advance Health Care Plan (AHCP) helps you to make plans for your future medical treatment and care needs. It sets out what quality of life would be acceptable to you and what treatments you would or would not agree to for your medical or health care.

In Queensland your AHCP might include:

• an Advance Health Directive
• an enduring power of attorney
• Statement of choices
• a letter to the person who will be responsible for your decision making
• an entry in your medical record
• instructions which clearly voice your view.

Preparing your AHCP encourages you to reflect on what is important to you, your beliefs, values, goals and preferences in life. It explains how you want to be cared for if you reach a point where you cannot communicate decisions about your medical care. It keeps you involved in your medical decisions, both now and in the future, whether you are healthy or have an illness.

Advance care planning becomes important should you become so unwell that you are no longer able to make decisions or communicate about your medical and care needs. By creating a plan in advance, your doctors and family can understand how you would like to be cared for. Your family and friends will find it easier to make informed decisions on your behalf, because you have explained your wishes and what is important to you.

Statement of Choices

Queensland Health has made planning easier by developing a Statement of Choices form. Your Statement of Choices focuses on your values, wishes and beliefs. It is not a legal document and you do not have to use it, you may have a different format, or you may wish to write this information out in your own document. It is a record of your future preferences for care and medical treatment. It can help your substitute decision maker to make health care decisions if you are not able to make decisions for yourself. The information contained in in your statement can be used to guide the way you are cared for.

If you want to utilise the Queensland Health Statement of Choices, chose the correct form from the two options below:

If you are filling out an advance care plan for yourself:

• Download and complete the Statement of Choices Form A (PDF, 453KB).
• Form A can be completed by an adult with the capacity to make decisions about their health care into the future.
• Do NOT complete Form B.

If you are filling out an advance care plan on behalf of someone else:

• Download and complete the Statement of Choices Form B (PDF, 456KB).
• You can only complete Form B on behalf of another adult if you are their substitute decision maker if they do not have the capacity to make decisions about their health or communicate those wishes.
• Do NOT complete Form A

Care Plans

It’s a good idea to have a care plan. The people who provide care (aged care workers, health care workers, nurses) may be able to help develop a care plan to best support your care needs. A good care plan may:

• show how pain and other symptoms might be managed
• show how cultural, emotional and spiritual support can be provided
• help family members make decisions about care options
• help those involved know what to expect
• show how support to families and carers through the bereavement process could be provided.

Building your own casket or a casket for your loved one

Below you will find plans to make your own casket. Please note that if you intend to cremate, cremation chambers in Brisbane vary in size. These plans are fairly standard size, however if you need a very large casket, you will need to check the chamber size and you may also need extra bracing. Please don’t hesitate to get in touch if you have any questions.

I would like to thank Steve Davidson,  Adrian Davidson and Rod Secomb for these plans. Steve has prepared these plans and generously provides them to you from the casket he, Adrian and Rod made for their brother and nephew Russell Davidson.

Dying and the health care system

Dying is something that happens to your whole being, not just your physical body and can beging long before you actually die

Your quality of life, medical treatment and pain control are all important matters. Pain control is important, as there is no need to suffer unnecessarily. If you are physically comfortable you can go through the process, you can be with friends and family, reflect on your life and your relationships with others, and grieve and express your love. It may be a time of growth, emotionally and spiritually for you and those you love.

In 2015 Australia was ranked second in the world when in the Qualitive or Death index. We have this high rating do to:

• A strong national palliative care policy framework;
• high levels of public spending on healthcare services;
• availability of opioid analgesics;
• extensive palliative care training resources for general and specialised medical workers;
• subsidies to reduce the financial burden of palliative care;
• Wide availability of opioid analgesics;
• strong public awareness of palliative care

Palliative Care

The legal definition of palliative care varies between each Australian State and Territory. Generally however palliative care is an act or omission, medical procedure or other measures to maintain or improve the comfort of a person who is, or would otherwise be, subject to pain and suffering. Some definitions also refer to it as the relief of pain, suffering and discomfort.

In practice, palliative care is broad and can include pain medication, oxygen, intravenous or nasogastric feeding, delivery of blood products, anti-nausea medication and anti-anxiety medication. Counselling and spiritual interventions may also provide palliative care.

Palliative care is aimed at ensuring dignity, compassion, equity and respect for the person at the end of life. In Queensland there is palliative care services available for adults and there is one available for children.  Your palliative care team will be able to answer any questions you have, and your questions will likely change over time. Here are some questions that you may ask:

• What is palliative care?
• Will anything be lost by opting for palliative care?
• How long do other people with this illness usually live?
• What will my quality of life be?
• What might I expect in the future with pain and other symptoms?
• Are there treatments which will lead to recovery?
• Are there treatments that will extend life?
• What are the side effects of treatment or medication?
• I am worried that….. will happen. What can be done to prevent it or alleviate it?
• Can you advise me on committing to a holiday or event in the future?
• What are good days going to be like?
• What are bad days going to be like?
• How can I explain what is happening to others?

Euthanasia and Assisted Suicide

Euthanasia is a deliberate, intentional act of one person to end the life of another person in order to relieve that person’s suffering. For example, a doctor injects a patient with a lethal substance to relieve that person from unbearable physical pain. The term euthanasia is often used in different ways. Three of the most common are:

• Voluntary euthanasia: Euthanasia is performed at the request of the person whose life is ended, and that person is competent. For example, a doctor injects a competent patient, at their request, with a lethal substance to relieve that person from unbearable physical pain.
• Non-voluntary euthanasia: Euthanasia is performed and the person is not competent. For example, a doctor injects a patient in a post-coma unresponsive state (sometimes referred to as a persistent vegetative state) with a lethal substance.
• Involuntary euthanasia: Euthanasia is performed and the person is competent but has not expressed the wish to die or has expressed a wish that he or she does not die. For example, a doctor injects a competent patient who is in the terminal stage of a terminal illness such as cancer with a lethal substance without that person’s request.

Suicide is the intentional act of killing oneself. Assisted suicide occurs where a person intentionally kills themselves with the assistance of another (who provides the knowledge or means to do it). For example, where a friend or relative obtains a lethal drug and provides it to the person to use to commit suicide.

Physician-assisted suicide occurs where a person requests a doctor to assist them in committing suicide, for example, a doctor provides a person with a prescription to obtain a lethal dose of drugs.

Is Euthanasia and Assisted Suicide legal in Australia?

Euthanasia is illegal in all Australian States and Territories, and may result in a person being charged with murder, manslaughter or assisting suicide.

Assisted suicide is illegal in all Australian States and Territories except for Victoria. On 29 November 2017 the Victorian Legislative Assembly passed the Voluntary Assisted Dying Act 2017 (‘the Act’), which will legalise voluntary assisted dying (physician-assisted suicide) in Victoria from 19 June 2019.

The Act provides for and regulates access to Voluntary Assisted Dying, defined as ‘the administration of a voluntary assisted dying substance, and includes steps reasonably related to such administration’ (i.e. physician-assisted dying, not voluntary euthanasia)

Voluntary Assisted Dying will only be available to adults over 18 who live in Victoria, who are able to make their own decisions, suffering from an incurable illness, experiencing intolerable suffering, and expected to die within a year. The only exception is if the person is diagnosed with a neurodegenerative disease, illness or medical condition. In that case, a person may access VAD provided that disease, illness or condition is expected to cause death within 12 months. The legislation is very strict and includes 68 safeguards.

You can find more detailed information here

Organ Donation

Organ and tissue donation is a consideration which often arises at the end of life, both for people who are dying and their families. In some cases donation of organs and tissue may be relatively straightforward, and a person with capacity may specify their wishes in relation to donation. In other cases however, particularly where the person who is dying has impaired capacity, or where the potential donor has already died, the situation becomes more legally and ethically complex. Some people find that while it is generally easy to support the idea of organ and tissue donation, it becomes more difficult when confronted with a request to consent to the donation of a deceased family member’s organs.

Further information about donation is available at from the DonateLife Network, the lead Australian Government body for organ and tissue donation.