Refusal of Medical Treatment

Refusal of Medical Treatment

You, or someone appointed to represent you, can refuse medical treatment for a current medical condition by signing a Refusal of Treatment Certificate (the "Certificate").

"Medical treatment" means the carrying out of:

1. an operation; or
2. the administration of a drug or other like substance; or
3. any other medical procedure –
   but does not include palliative care.

It is illegal for medical practitioners to continue to treat you if they know that there is a valid Certificate in force.

The refusal of medical treatment does not cover procedures that would be considered palliative care. That is, reasonable pain relief, or food and water whilst you are still able to eat and drink. So, neither you, nor someone appointed to represent you, can use the Certificate to refuse palliative care.

A doctor must witness the signature, and the doctor or hospital/institution manager must give a copy of it to the Tribunal within Seven days.

Form for Competent Patient

Download the Refusal of Treatment form for yourself (mentally competent)—DWDV form 03.

Form for Agent of Incompetent Patient

Download the Refusal of Treatment form for someone else if you are acting as their Agent (mentally incompetent)—DWDV form 04.

Not a Living Will

As the refusal of medical treatment certificate applies only to a current condition and not to an illness or condition that may occur in the future: it may not be used as an "advance directive". The refusal of medical treatment certificate ceases to operate once the circumstances that gave rise to it are no longer relevant.

Can You Change Your Mind?

If you are competent, the Certificate can easily be cancelled at any time by completing and signing the Notice Of Cancellation section at the bottom of DWDV form 03 (see above).

Public Advocate Advice

Extract from The Office of the Public Advocate

1. Signing as a competent person

You can sign a Certificate if you are over 18 years of age and have the capacity to understand the decision you are making.

How does it work?

• You sign and have witnessed a Refusal of Treatment Certificate: Competent Person form.
• You specify the type of treatment you wish to refuse.
• Your treating doctor can only provide treatment according to the terms of the Certificate.

Requirements to sign

To sign you must:

• Have been given sufficient information about your condition
• Understand this information
• Understand what you are doing by signing the Certificate
• Make the decision voluntarily (advice can be given, but you must not be coerced).

A doctor and one other person must witness the signing and be satisfied that these requirements have been met.

2. Signing the Certificate as your agent or guardian

Someone appointed to represent you can refuse medical treatment on your behalf. This can be your:

• Agent, appointed by you under an enduring power of attorney (medical treatment), or
• Guardian, appointed by the Guardianship List of the Victorian Civil and Administrative Tribunal (the Tribunal).

How does it work?

• The agent or guardian signs and has witnessed a Refusal of Treatment Certificate: agent or guardian of incompetent person form.
• They specify the type of treatment they wish to refuse.
• The treating doctor can only provide treatment according to the terms of the Certificate.

Requirements to sign

To sign, an agent or guardian must:

• Have been given sufficient information about your condition
• Understand this information
• Understand what they are doing in signing the Certificate
• Make the decision voluntarily (advice can be given, but they must not be coerced),
• be convinced that either -
• The medical treatment would cause you unreasonable distress, or
• There are reasonable grounds for believing you would, after serious consideration, have considered the treatment unwarranted.

Safeguards

Anyone who has a genuine interest in your welfare can ask the Tribunal to consider the actions of the agent or guardian. The Tribunal can suspend or cancel an enduring power of attorney (medical treatment) or a guardianship order if an agent or guardian is not acting in your best interests.

If this happens, then any Certificate signed by the agent or guardian is also cancelled. The Tribunal will send a written notice confirming this to the hospital or your home. If you are not at home, the Tribunal will also notify your treating doctor.

Any beneficiary of your will or estate, who uses undue influence or acts deceptively to obtain a Certificate, will lose their entitlements under your will.

A Certificate cannot be used to aid and abet you to commit suicide. This would be an offence under the Crimes Act 1958 and could result in imprisonment.

Contact the Office of the Public Advocate for advice and further information.