Substitute decision making
All patients should have an Enduring Power of Attorney (EPoA).
The hierarchy for medical substitute decision making presently approved:
1. Person appointed enduring power of attorney (medical treatment)
An agent appointed by the patient under enduring power of attorney (medical treatment).
2. Person appointed by VCAT to make treatment decision
A person appointed by VCAT to make decisions about the proposed treatment.
3. Guardian appointed by VCAT to make medical/dental treatment decisions
A guardian appointed by VCAT to make decisions about medical/dental treatment.
4. Person appointed attorney for personal matters or enduring guardian with health care powers
A person appointed by the patient on or after 1 September 2015 as an attorney for personal matters under an enduring power of attorney or a person appointed by the patient before 1 September 2015 as an enduring guardian with health care powers under an enduring power of guardianship.
5. Person appointed by the patient, in writing, to make medical/dental treatment decisions
A person appointed by the patient, in writing, to make decisions about medical/dental treatment including the proposed treatment.
6. Patient’s spouse or domestic partner
The patient’s spouse or domestic partner.
7. Patient’s primary carer
The patient’s primary carer, including carers in receipt of a Centrelink Carer’s payment but excluding paid carers or service providers.
8. Patient’s nearest relative
The patient’s nearest relative over the age of 18 years, in the following order listed:
- adult son or daughter
- father or mother
- brother or sister (including adopted and half siblings)
Where there are two relatives in the same position (for example, a brother and sister) the elder person is the person responsible regardless of gender.
If the patient does not have any friends or family and there is no one with the legal authority to speak on their behalf, a Public Advocate can be appointed to represent them. The VCAT can appoint a guardian, including a Public Advocate, for a person with disability who is 18 years of age or over.