Most people who need one haven't made one. By the time they need it, they can't.
An advance health directive (AHD) is a legal document that records a person's wishes about medical treatment — for situations where they've lost the capacity to make those decisions themselves. Governed by the Powers of Attorney Act 1998 (Qld), it's one of the most important estate planning documents Queensland residents can make. And one of the most commonly overlooked.
What Is an Advance Health Directive?
Put simply: it's instructions for doctors about what a person does and doesn't want — covering consent to treatments, refusal of treatments, and the circumstances under which those decisions apply.
Queensland's AHD — in the person's own words, not whoever happens to be available.
Called a 'living will' in some other states, and an 'advance care directive' elsewhere, Queensland uses the specific term advance health directive. The Queensland Government's guidance on AHDs covers the requirements in detail.
Different from an enduring power of attorney.
Enduring powers of attorney for health matters appoint another person to make decisions on the maker's behalf. An AHD records the maker's own wishes about specific situations. Both can work together — the AHD handles the situations it covers; the attorney handles everything else. Making one without the other leaves gaps.
Who Can Make One — and When It's Too Late
Adults. Over 18. With capacity at the time of signing.
Those are the requirements. The capacity requirement is the one that catches people out. A person who has already lost the cognitive ability to understand what they're signing — due to dementia, a stroke, a serious accident — cannot make a valid AHD. The document cannot be made on their behalf by a family member or attorney.
That's the brutal logic of the document.
It can only be made while the maker can make it — once capacity is lost, the opportunity is gone.
How to Make a Valid AHD in Queensland
Queensland's AHD has specific formal requirements that differ from other powers of attorney.
Queensland law requires the use of Form 4 — the Advance Health Directive form, available from the Office of the Public Guardian. Documents from other Australian states don't automatically apply in Queensland.
Doctor witness is the requirement that surprises most people.
Queensland AHDs must be witnessed by a doctor — a medical practitioner. Not a Justice of the Peace. Not a solicitor. A doctor. Other Queensland powers of attorney can be witnessed by a JP or solicitor, but the AHD requires a medical witness because the doctor must certify that the maker appears to have the capacity to understand what they're signing.
Witnessing doctors cannot be the maker's spouse, and cannot be involved in the maker's care.
Getting this wrong invalidates the document.
What an AHD Can — and Cannot — Cover
Life-Sustaining Treatment
Most significant in most AHDs is the life-sustaining treatment provision.
A person can use an AHD to refuse specific interventions if they are in a particular condition — cardiopulmonary resuscitation (CPR), mechanical ventilation, artificial nutrition and hydration, dialysis, and similar measures used to keep someone alive when their body cannot do so unaided. These are the decisions that families and clinicians most commonly struggle with in the absence of clear instructions.
Refusal only applies in the circumstances the person specifies.
Someone might refuse CPR if they are in a persistent vegetative state, but not if there's a reasonable prospect of recovery. The specificity of those conditions is what makes the document useful — and what makes it worth taking the time to complete carefully rather than quickly.
What Cannot Be Included
Nothing in an AHD can constitute a voluntary assisted dying request — that is a separate, strictly regulated process in Queensland. Documents of this kind set out wishes and directions for healthcare providers; they cannot override the law or constitute clinical prescriptions.
When an AHD Takes Effect
Not yet.
Dormant until it's needed. While the maker retains capacity to make their own healthcare decisions, doctors speak directly to the patient — not the AHD. Capacity lost is the trigger for the document to operate.
People who regain capacity after a period of incapacity can make their own decisions again. The AHD steps back. Not a permanent handover — a contingency.
If There Is No AHD — Who Decides?
Without an AHD, the hierarchy of decision-makers under the Guardianship and Administration Act 2000 (Qld) takes over.
First in line is the person's statutory health attorney — which in Queensland operates in this order: a spouse or de facto partner (including same-sex partners), then a carer, then a close friend or next of kin aged 18 or over. If a guardian has been appointed by the Queensland Civil and Administrative Tribunal (QCAT), the guardian takes priority.
None of these people know what the person would have wanted.
They have to make decisions in good faith, based on what they think is in the person's best interests. That's a difficult position to put anyone in — particularly where family members disagree. An AHD removes the uncertainty. It also removes the burden from the people the maker cares about.
Revoking or Changing an AHD
Changed circumstances are common. Revocation is simple.
Revocation is available at any time while the maker still has capacity to do so. Written, signed, and witnessed — that's generally how it's done. In some circumstances, expressing a clear intention to revoke directly to a doctor may also be effective.
Marriage and divorce do not automatically revoke an AHD in Queensland.
That's worth noting. In some Queensland powers of attorney, certain events trigger automatic revocation — but the AHD doesn't work that way. Forgetting to update it after divorce is a common oversight. Reviewing the document after major life changes — diagnosis, separation, new relationship, change in values — is good practice.
To change specific directions, the best approach is revocation and replacement.
Keeping It Useful — Storage and Access
Filing it away without discussing it with family or the treating doctor creates its own problems.
Keep the original somewhere accessible — a hospital bag, with the treating doctor, or with close family. Register a copy with Queensland Health's AHD Register — it's accessible to healthcare providers in emergencies. Copies should be given to the treating GP, any attorney appointed under a separate enduring power of attorney, and to close family members who may be involved in decisions.
Discuss it too.
An AHD that sits in a file without ever being discussed with family or the treating doctor creates its own problems. People find the conversation uncomfortable. Having it anyway — explaining the document's existence and where it's kept — is the part of the process that actually makes the document effective in practice.
Getting Legal Advice
Estate planning that includes an AHD, an enduring power of attorney, and a will covers the most common gaps that arise when health fails or capacity is lost. A Queensland estate planning lawyer can help draft an AHD that is specific, valid, and genuinely useful when it matters.
Frequently Asked Questions
An AHD — What Is an Advance Health Directive in Queensland?
An advance health directive (AHD) is a legal document made under the Powers of Attorney Act 1998 (Qld) in which a person records their wishes about future healthcare — for situations where they can no longer make decisions themselves. It can specify consent to treatment, refusal of treatment, and conditions around life-sustaining measures.
Only a Doctor — Who Can Witness an AHD in Queensland?
Only a doctor — a medical practitioner — can witness an AHD in Queensland. This distinguishes an AHD from other Queensland powers of attorney, which can be witnessed by a Justice of the Peace or solicitor. The witnessing doctor must certify the person appears to have capacity and must not be involved in the person's care.
Without an AHD — Who Makes Medical Decisions?
Without an AHD, decisions fall to the statutory health attorney under the Guardianship and Administration Act 2000 (Qld). The hierarchy is: spouse or de facto partner first, then a carer, then a close friend or next of kin aged 18 or over. A court-appointed guardian takes priority if one has been appointed by QCAT.
Yes — Can an AHD Be Revoked?
Yes. An AHD can be revoked at any time while the person has capacity to do so. Revocation should be in writing, signed and witnessed. Marriage and divorce do not automatically revoke an AHD in Queensland — makers should review the document after significant life changes.
Distinct Documents — What Is the Difference Between an AHD and an Enduring Power of Attorney?
Distinct documents with different purposes. An enduring power of attorney (EPA) appoints another person to make decisions on the maker's behalf. An AHD records the maker's own wishes about specific treatment situations. Both can work together — the AHD specifies wishes, and the EPA covers situations the AHD doesn't address.
Disclaimer
This article is for general informational purposes only and does not constitute legal advice. Queensland estate planning law, including advance health directives, is subject to change. Readers should seek independent legal advice from a qualified Queensland estate planning or elder law practitioner regarding their specific circumstances.
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