Health care consent line
***Due to the current COVID-19 pandemic, the Office of the Public Guardian (OPG) recognises the understandable increase in apprehension surrounding consent for health care for people with decision making impairment. Please note the Health Care Consent Line operating hours were not changed as a result of COVID-19.
For OPG, the processes involved in obtaining consent regarding adults with impaired decision making capacity, both for treatment and for withholding/withdrawing life sustaining measures, have not changed.
Health providers are encouraged to utilise the legislated ‘urgent’ healthcare provisions in the Guardianship and Administration Act 2000 where appropriate.***
The Office of the Public Guardian provides consent for health care matters for adults if their decision making capacity is permanently or temporarily impaired.
We can provide this consent as:
- their guardian
- their attorney under an Enduring Power of Attorney
- a Statutory Health Attorney of last resort
Health providers requiring a health care consent can call our health care line and speak to a delegate guardian. This line is open Monday-Friday 7am-7pm and Saturday, Sunday and public holidays 9am-5pm.
Outside of these hours, there is a message bank and email address allowing health providers to leave their details for OPG staff to prioritise returning their call upon resumption of operating hours.
Please note that if you are requesting consent as the Statutory Health Attorney of last resort you should first have made all reasonable attempts to contact an appropriate decision maker in the adult’s life.
We cannot provide consent for health care for people under 18 years of age.
Health care consent is required for treatments such as:
- Surgery
- Withholding or withdrawal of life sustaining measures
- Endoscopy or colonoscopy
- Pap smear
- Dental treatment such as fillings or teeth removal
Health care consent is not required for treatments such as:
- Urgent health care. If the treatment is needed to prevent immediate harm or suffering to the adult with impaired decision making capacity, it can be undertaken without consent. This includes the prevention of significant pain or distress to the adult where it is not reasonably practicable to get consent from the adult.
- Minor and uncontroversial health care such as first aid, non-intrusive examinations such as a visual examination and giving medication normally obtained without a prescription.
Withholding or withdrawing life sustaining measures
The process for OPG to provide consent for the withholding or withdrawal of life sustaining measures for an adult with impaired decision making capacity for health care decisions follows a framework that is underpinned by legislation and requires approval from Senior Officer, or Senior Executive staff within OPG.
Therefore, OPG strongly advises any health care providers who have adults on their ward for whom they believe they may need to seek consent from OPG to withdraw or withhold life sustaining measures in the near future, to proactively commence the consent process during the phone line operating hours. This should mitigate the need to seek a consent outside of these hours.
In an acute emergency, life sustaining measures are able to be carried out by health care providers without consent in line with legislation under the Guardianship and Administration Act 2000 if the adult has impaired capacity for health care decisions. Additionally, under this legislation, a life-sustaining measure may be withheld or withdrawn for an adult by the health care provider without consent, if the health provider considers:
- the adult has impaired capacity for the health matter concerned, and
- the commencement or continuation of the measure for the adult would be inconsistent with good medical practice.
The decision to withhold or withdraw the life sustaining measure must be taken immediately and must be consistent with good medical practice. The measure may not be withheld or withdrawn without consent if the health provider knows that the adult objects to it.
Advance Health Directives
If an adult has an Advanced Health Directive that has been sighted by the health provider, the adult’s wishes must be followed with regards to both treatment and the withdrawal/withholding of life sustaining measures. Consent is not needed from the OPG for treatment or the withdrawal/withholding of life sustaining measures where an adult has a valid Advanced Health Directive.
For a health care consent for an adult with impaired decision making capacity, please call 1300 753 624.