Refusing Advance Refusals: Advance Directives and Life-Sustaining Medical Treatment

Abstract

The law recognises the right of a competent adult to make an advance refusal of life-sustaining medical treatment. However, this right is not unqualified and there are circumstances in which a health professional or a court will be permitted to disregard an advance directive. Underpinning this qualified right is the tension between the principles of self-determination or autonomy, and sanctity of life. This article explores the excuses available in Australia to health professionals who do not wish to comply with an advance directive. It compares the common law with those jurisdictions that have enacted legislation, and evaluates and critiques the different excuses available.

Keywords: Advance directives, Adult guardianship law, End of life decision-making, Living wills