An advance care directive (ACD) is a direction that you give, prior to losing capacity, about the treatment you wish to receive once you have lost capacity.

ACDs are being developed to encompass not only health directions, but lifestyle decisions as well. For example, if you have an episodic mental illness you may develop an ACD that sets out the care you wish to receive, the sorts of treatment you have found useful (or not useful) and how side effects may be alleviated. The ACD may also specify whom you wish to have caring for your children while you are in hospital, and who should look after your money and care for your property and pets.

The legal status of ACDs is unclear in relation to medical treatment, because once you have lost capacity the "person responsible" is legally authorised to consent to medical treatment on your behalf (see: "Consent to medical treatment", above). However, the Supreme Court of Western Australia affirmed the directive status of an ACD for a man with quadriplegia who wished to refuse treatment (see: Brightwater Care Group v Rossiter [2009] WASC 229). ACDs governing mental health care may be overridden should you be made an involuntary patient under the Mental Health Act 1986 (Vic).

Clearly, ACDs are a key source of information about what you want to have happen. The most authoritative ACDs are those developed in consultation with your health professionals and regularly reviewed in the light of your health needs and scientific developments.

It is wise to develop an ACD in consultation with your enduring attorney (financial), medical power of attorney and enduring guardian. For further information regarding these matters, see: Chapters 16*4 Psychiatric Disability and 16*7 Powers of Attorney.