Healthcare decisions
What are healthcare decisions?
Healthcare decisions involve choices about your health and wellbeing. These include consenting to medications, treatments, surgeries or therapies for physical and mental health.
What types of healthcare decisions might you need to make?
Healthcare decisions can include:
- Medications you take
- Medical treatments or surgeries
- Dental care or therapies
- Preventative physical or mental health care
- End-of-life care.
Who can make healthcare decisions for you?
If you’re unable to make healthcare decisions yourself, your healthcare provider will seek consent in the following order:
- Advance health directive (AHD) : if you have an AHD, your healthcare provider must follow it first.
- Guardian: if you don't have an AHD, your healthcare provider will check if you have a guardian appointed by Queensland Civil and Administrative Tribunal (QCAT).
- Attorney: if there is no guardian, they'll look for an attorney you’ve appointed under an Enduring power of attorney (EPOA) or AHD to make decisions on your behalf.
- Statutory health attorney (SHA): If none of these options exist, a SHA will be used to make healthcare decisions as a last resort.
What is a Statutory Health Attorney?
A Statutory Health Attorney (SHA) can make healthcare decisions for you without needing a formal appointment during periods when you have impaired capacity.
The public guardian can act as your SHA if no-one else is available, culturally appropriate to make a health care decision or contactable by your healthcare provider.
This is typically for one-off decisions and doesn’t usually require formal appointment as your guardian.
For more information visit Statutory Health Attorney.
When can we make healthcare decisions?
We can make healthcare decisions for you when acting as your:
- Statutory health attorney (SHA) of last resort
- Guardian (appointed by QCAT for healthcare)
- Attorneys (under an enduring power of attorney or AHD).
We cannot make healthcare decisions for people under 18 years of age.
When is a healthcare decision needed?
Healthcare decisions are required for most medical treatments. However, in some cases your provider can treat you without your permission or the permission of a guardian or attorney. These cases include:
- Urgent healthcare: to save your life, prevent serious harm, or alleviate significant pain or distress, provided there’s no known objection in an AHD.
- Minor and uncontroversial healthcare, such as antibiotics or tetanus injections, can also be carried out without consent if it promotes the adult’s health and well-being, and there’s no known objection or dispute.
- Hospital admissions, transfers, and referrals: when necessary for your care.
- For end-of-life care: life-sustaining measures may be withheld or withdrawn if continuing them is inconsistent with good medical practice, but only with appropriate consent unless it’s an acute emergency. In emergencies, life-sustaining measures can be withheld or withdrawn immediately if medically necessary, unless you have objected.
If you object to a treatment, it’s no longer considered minor, and consent must be sought.
What guides our decision-making?
Our decisions follow the Guardianship and Administration Act 2000, OPG’s Health Care Framework, and the Structured Decision-Making Framework . These frameworks ensure that:
- Your human rights, wishes, preferences and needs are respected
- You’re supported to make your own decisions where possible
- Decisions are made based on your views, wishes and preferences.
This approach ensures that decisions are made in a way that upholds your autonomy and dignity while protecting your rights.
What do we consider when making decisions?
We consider:
- Your medical condition and prognosis
- Alternative treatments and their risks
- Whether the treatment can be delayed (e.g. if you might regain decision-making ability, or if a better treatment might soon be available)
- Your views and wishes, or input from family about what your views and wishes would be if you can’t communicate.
Your safety and wellbeing will always be our top priority.
What information does your healthcare provider need to give us?
To help us make a decision that focuses on maintaining and promoting your health and wellbeing, your healthcare provider must provide:
- Details of your medical condition
- The proposed treatment or procedure, including benefits, risks, and side effects, as well as information about any potential alternative treatments and the consequences if treatment is not provided
- Whether an anesthetic is required
- Whether you’ve been consulted and if you object to it.
Our focus is to maintain your health and wellbeing at all times. This information helps us make informed decisions to support this commitment.
When is permission not needed to treat you?
In some cases, your healthcare provider can treat you without your permission or the permission of a guardian or attorney. These cases include:
- Urgent healthcare: to save your life or to prevent harm
- Emergency withholding or withdrawal of life-sustaining treatment
- Minor and uncontroversial healthcare: for example, giving antibiotics or a tetanus injection
- Hospital admissions, transfers and referrals: when necessary for your care.
What healthcare decisions can only be made by a tribunal or court?
Some healthcare decisions, called ‘special healthcare,’ can only be made by QCAT or the Supreme Court. Special healthcare includes:
- Tissue donation while you’re alive
- Sterilisation
- Termination of a pregnancy
- Experimental healthcare or medical research
- Electroconvulsive therapy.
How long does it take to make a decision?
Once we've received the necessary healthcare information, we aim to make a decision quickly (within 24 hours) to ensure your health and wellbeing is prioritised.
Complex cases or conflicts between family and healthcare providers may take longer.
For urgent healthcare, consent isn’t required if treatment is needed to prevent pain, distress, harm or threat to life.
How can your healthcare provider contact us?
If your healthcare provider needs our consent to treat you, they can:
- Call our healthcare consent line on 1300 753 624
- 9am–5pm, every day including weekends and public holidays.