Medical Treatment Decision Makers in Victoria

Medical Powers and the Current Victorian Appointment

Victoria’s current appointment names a medical treatment decision maker under the Medical Treatment Planning and Decisions Act 2016. Use the actual document and its powers to identify the role, even when a client calls it an enduring medical power of attorney.

The roles address different decisions:

Role	What the role permits	What establishes authority
Medical treatment decision maker	Makes a treatment decision when the patient cannot make that decision	A valid appointment or the statutory hierarchy
Support person	Helps the patient understand information and communicate their own decision	A support-person appointment
Financial attorney	Makes financial decisions within the powers granted	The financial appointment and its commencement terms

A support person does not receive substitute consent authority merely by holding that role. One individual can hold more than one appointment, but the file must identify the authority used for each action. The Department of Health provides separate forms for these medical roles.

For the separate money-management appointment, use the financial power of attorney guide. Wider personal decisions belong to the relevant enduring guardianship arrangements.

When Someone Else Can Decide Treatment

The patient makes their own informed treatment decision while they have capacity for that decision. A diagnosis, age or inability to manage finances does not alone establish inability to decide treatment.

Capacity involves understanding relevant information and the decision’s effect. The person must retain information as needed, use or weigh it and communicate their decision by some means. Communication can include gestures. Give the person the support they need before concluding they cannot decide. The Office of the Public Advocate’s capacity guidance explains this decision-specific assessment.

When the person lacks capacity, identify any valid and relevant instructional directive in their advance care directive. That directive can already consent to or refuse the proposed treatment. Otherwise, the medical treatment decision maker decides, guided by the person’s relevant values directive and other known preferences. Their task is to decide as the patient would have decided.

Emergency treatment has a separate legal route. The Public Advocate’s emergency guidance explains when urgent treatment can proceed without consent. A known relevant refusal in an instructional directive or valid older refusal certificate changes that position. Other exceptions, including treatment when no decision maker exists, require the applicable statutory process. Avoid treating the appointment as a universal consent requirement.

Appoint and Identify the Decision Maker

To appoint a Victorian medical treatment decision maker, use the official appointment form and complete its signing and acceptance requirements. The appointing adult must have capacity to make the appointment.

Download the Department of Health’s appointment of medical treatment decision maker PDF. Its short form accommodates two appointees. The forms page also has a long form and a version for someone signing at the appointor’s direction.

Use this appointment checklist:

1. Confirm the client understands the appointment and chooses freely. Record the capacity assessment for making this document separately from any later treatment-capacity assessment.
2. Complete the appointor’s identifying details and each appointee’s details. Put appointees in their intended order and record any conditions or limits.
3. Arrange two adult witnesses for the appointor’s signature. At least one must be a registered medical practitioner or a person authorised to witness affidavits. Neither can be an appointee in the document.
4. Have the appointor sign in both witnesses’ presence. Complete the witnesses’ certifications and any interpreter section that applies. Use the dedicated form if another person must sign at the client’s direction.
5. Obtain each appointee’s signed acceptance before an adult witness. Acceptance can occur later and does not require the same two witnesses who witnessed the appointor.
6. Keep the original accessible and give copies to the appointees and relevant treating services. Supply any advance care directive alongside it.

The PDF fields can be completed on screen. Print it for the handwritten signing and witnessing sections, following the Department’s instructions. Review the official appointment checklist with the form. Victoria does not register these appointments.

Identify Who Acts at the Treatment Decision

Only one Victorian medical treatment decision maker acts at a time. Among listed appointees, it is the first who is reasonably available and willing and able to act. Listing several people does not create a family vote.

Where no appointed person can act, apply the Victorian statutory hierarchy. A guardian with the relevant medical power comes next. Then consider the first qualifying person in a close and continuing relationship with the patient:

1. Spouse or domestic partner.
2. Primary carer, excluding a paid service provider.
3. Adult child.
4. Parent.
5. Adult sibling.

Availability and willingness still matter. Where relatives occupy the same highest category, the eldest qualifies. A hospital’s next-of-kin contact entry does not itself establish this authority. If nobody qualifies, the treating team follows the statutory route for treatment without a decision maker.

Fictional Completed Appointment-Check Record

In this fictional file, Ellen appoints her daughter Priya first and her son Tom second. Ellen’s appointment has completed witness certifications and both witnessed acceptances. No later appointment or revocation appears in the documents supplied.

Check	Recorded result	Supporting document
Appointment	Victorian medical treatment decision maker appointment, signed while Ellen has appointment capacity	Executed form and solicitor’s attendance note
Current treatment decision	Clinician records Ellen lacks capacity for the proposed procedure after communication support	Treatment-specific clinical assessment
Advance care directive	Supplied directive contains values relevant to care, with no instructional decision covering this procedure	Directive and treating team’s applicability record
Acting person	Priya cannot be contacted within the clinically relevant period. Tom is reasonably available, willing and able	Contact attempts and Tom’s confirmation
Shared identification	Treating team and solicitor identify Tom from the same appointment and availability record	Copy on each file and communication note

Keep the complete documents behind this short record. The table records the reasoning and its evidence. It does not replace execution of the appointment or the clinical consent record.

Check an Older Medical Appointment

Victorian transitional rules preserve authority under some older medical appointments. Its title alone does not establish whether it remains effective.

Identify the making period and the legislation used. Older enduring medical powers, some enduring personal powers and older enduring guardianship appointments enter through different transitional provisions. Use the Department’s previous-appointment guidance for the exact calendar boundaries.

Then check the powers actually granted, execution and acceptance requirements that applied when it was made. Read later appointments, revocations and any relevant tribunal orders. A financial-only power does not become a medical appointment because it is enduring.

For an interstate document, identify its home jurisdiction and validity there, then its recognition and scope in Victoria. The Public Advocate confirms recognition of valid appointments from other Australian jurisdictions. That recognition does not expand a financial appointment into healthcare authority. Keep a copy of the instrument and the recognition analysis with the treatment file.

For a new Victorian appointment, use the current medical treatment decision maker instrument. An older enduring power of attorney medical treatment template is relevant to assessing an existing document, not the form to select for a new appointment.

Queensland Healthcare Authority is Different

Queensland uses an enduring power of attorney, an advance health directive and a statutory health attorney framework for healthcare decisions. A Victorian appointment form does not establish a new Queensland appointment.

For an adult with impaired capacity for the health matter, section 66 of Queensland’s Guardianship and Administration Act 2000 sets the order. Start with a relevant direction in an advance health directive. If that does not apply, identify a guardian or tribunal order for the matter. Next comes the authorised attorney under the relevant enduring document, then the statutory health attorney. Treatment permitted without consent follows its separate statutory rules.

The Public Guardian’s healthcare guidance explains the consent route. A statutory health attorney is identified by law from eligible people who are readily available and culturally appropriate. The order starts with a close and continuing spouse relationship, then an unpaid carer and then a close friend or relation. The Public Guardian is the final option when nobody suitable is available.

An attorney’s healthcare power operates only when the adult lacks capacity for that health decision. Financial commencement can work differently. Read the powers and conditions for each matter, even where the same person holds both roles.

The Queensland enduring power guidance explains the short and long forms. Use the official forms and explanatory guides for execution. An advance health directive also allows treatment directions and an attorney appointment. Its official guidance explains commencement and the additional requirements for life-sustaining treatment directions.

Healthcare Authority in NSW and South Australia

For NSW healthcare consent, identify an enduring guardian or the statutory person responsible. South Australia uses an advance care directive to appoint substitute decision makers.

NSW

In NSW, an enduring guardian can receive medical and dental consent functions. A power of attorney deals with financial and legal decisions. The NSW appointment guidance explains the functions that can be granted.

For a patient aged 16 or older who cannot consent, the NSW person responsible hierarchy starts with a guardian holding the relevant authority. It then moves to a close and continuing spouse or de facto partner, an unpaid carer and a close relative or friend. Treatment categories, objections and emergency rules affect the consent route. An unresolved consent question can require the NSW Civil and Administrative Tribunal.

A new enduring guardianship appointment needs the appointor’s signature and the appointee’s acceptance, witnessed by eligible witnesses. The Legal Aid NSW appointment explanation describes the eligible legal witnesses and their certificates. Keep any valid advance care directive with the appointment.

South Australia

South Australia’s advance care directive can appoint substitute decision makers and record future healthcare wishes. It does not grant financial authority. Use the South Australian official directive route, including when assessing an older medical power of attorney.

The Office of the Public Advocate’s directive guidance explains the authorised witness and signing sequence. Appointed substitute decision makers accept before the person signs with the witness. Use the official advance care directive form and its instructions. Substitute decision making applies when the person cannot make the particular decision. A separate financial power is needed for decisions about money.

Keep Treatment Decisions Separate From Payments

Treatment consent and payment authority answer different questions, even when the same care episode produces both records.

In this fictional example, Tom consents to Ellen’s procedure as her acting medical treatment decision maker. Ellen’s financial attorney, Mira, receives a $680 care invoice. Mira checks her financial authority and arranges payment from Ellen’s account. Tom’s treatment appointment alone would not authorise that withdrawal.

Keep the two records side by side:

Record	Documents to retain	Question answered
Healthcare	Appointment, relevant directive, capacity assessment and consent note	Who could decide this treatment, and what did they decide?
Financial	Financial authority, commencement evidence, invoice and bank payment	Who could use the money, and which payment met this invoice?
Payment trace	Fictional invoice CARE-184 for $680, matching debit and reference to Ellen-account.pdf, page 4	Where does the bank record show the payment?
Follow-up	Any discrepancy between invoice and debit, plus the explanation obtained	What remains to reconcile?

A payment ledger establishes transactions shown in the supplied statements. It does not establish medical capacity, treatment consent or a lawful appointment. An invoice likewise cannot prove that its payer had authority to operate the account.

For statement-heavy care-payment reviews, FinTrace saves solicitors hours of conversion and review by analysing the supplied bank statements. Its searchable ledger and findings report cite source PDF filenames and pages, so you have the payment evidence at hand. The service flags suspicious transactions and gaps in supplied statements at a fraction of the cost of manual statement review. Financial concerns about an attorney’s payments belong in the attorney transaction review alongside the authority documents.

Resolve Unclear Authority or Disagreement

Clarify the disputed decision and its authority before treating a family disagreement as a power to override the patient or appointee.

Ask the treating team to identify the proposed treatment and the patient’s capacity for that decision. Ask which directive applies and whether its instructions address the treatment. Obtain the appointment holder’s complete instrument, any conditions and the basis on which they say they are the acting person. Record contact attempts where a higher-listed person is unavailable.

Retain the clinical explanation, appointment versions and communications about the dispute. Separate disagreement about treatment from a concern about appointment validity or a financial payment.

The Victorian Office of the Public Advocate provides medical decision-making guidance. For unresolved legal questions, the Medical Treatment Planning and Decisions Act gives the Victorian Civil and Administrative Tribunal powers concerning capacity, directives and appointments. The application route depends on the issue. The tribunal’s medical treatment application guidance identifies the available requests. Keep urgent clinical questions with the treating team while the appropriate legal route is arranged.

Healthcare Appointments in WA and Tasmania

Western Australia and Tasmania use enduring guardianship arrangements for appointed healthcare decision makers. Each jurisdiction has its own instrument and consent framework.

Western Australia

A WA enduring power of guardianship can grant treatment functions when the person cannot make the decision themselves. An advance health directive records the person’s own treatment decisions. A relevant directive takes priority over a guardian’s decision, subject to the legal exceptions.

Use the WA Public Advocate’s enduring guardianship forms and guide for a new appointment. The appointor and appointee signatures each need two eligible witnesses, including one authorised witness. The WA Health consent guidance explains the treatment hierarchy and urgent-treatment exceptions. Where a directive does not cover the decision, the treating team identifies the first authorised person available under that hierarchy. A financial enduring power addresses money and property separately.

Tasmania

Tasmania uses an enduring guardianship instrument which must be registered with the Tasmanian Civil and Administrative Tribunal. The Public Guardian’s appointment guidance and official instrument links explain registration through Service Tasmania. The instrument sets the healthcare powers and any limits. An enduring guardian acts within those powers when the person loses capacity for the decision.

Where substitute medical consent is required, identify the Tasmanian person responsible. The hierarchy starts with a guardian holding the relevant authority, then a close and continuing spouse, a carer and a qualifying close family member. That category can include a friend providing ongoing personal support. Advance care directives inform the treatment decision. Urgent and special treatment have separate rules, so a family connection alone cannot settle every consent question.

For another state or territory, the Australian Government’s advance care directive guidance links to state-based forms through Advance Care Planning Australia. Identify the healthcare instrument for the place of treatment, then document financial authority separately before anyone withdraws money or pays care expenses.