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Commonly Asked Questions about Legal Documents for Health Care

Advance directives and living wills are legal documents that give instructions to your family members, health care providers, and others about the kind of care you would want to receive if you can no longer communicate your wishes because you are incapacitated by a temporary or permanent injury or illness.
Types of Medical Records EHR (Electronic Health Records) EHRs are comprehensive digital records that consolidate your health information in one secure location. PHR (Physical Health Records) Medical History Records. Medication Records. Immunization Records. Laboratory and Test Results. Progress Notes. Surgical Records.
An advance directive is a written instruction made by a capable adult who gives or refuses consent to health care in the event that the adult is not capable of giving instruction at the time the health care is required.
You can use an Advance Health Care Directive to say who you want to speak for you and what kind of treatments you want. These documents are called advance because you prepare one before healthcare decisions need to be made.
If the patient is not capable, a substitute decision maker (SDM) makes decisions about treatment. The person(s) ranked highest on the list below would be the patients SDM: Rank of substitute decision makers from the Health Care Consent Act: A guardian with the authority to give or refuse consent to treatment.
You (the principal) can sign a power of attorney document, which authorizes someone else (your agent or attorney-in-fact) to act or make decisions on your behalf.
Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself.
Be clear, legible, concise, contemporaneous, progressive and accurate. Include information about assessments, action taken, outcomes, reassessment processes (if necessary), risks, complications and changes. Meet all necessary medico-legal requirements for documentation. Documentation of information | Australian Commission on Safety safetyandquality.gov.au nsqhs-standards safetyandquality.gov.au nsqhs-standards