Medical Treatment Decision Makers in Victoria: Appointments, Powers and Disputes

Direct answer

A medical treatment decision maker in Victoria is a person who has authority under the Medical Treatment Planning and Decisions Act 2016 (Vic) to make medical treatment decisions for another adult, but only when that adult lacks decision-making capacity for the particular treatment decision. A Victorian adult with capacity may appoint one or more medical treatment decision makers on the current approved form, specifying an order of priority; the first appointee in that order who is reasonably available, willing and able acts for a given decision. If there is no valid appointment covering the decision, the Act identifies the medical treatment decision maker through a statutory hierarchy that starts with a guardian appointed for medical treatment decisions, then a spouse or domestic partner, then a primary carer, and then specified relatives, subject to eligibility conditions and the “reasonably available, willing and able” test. The decision maker must apply any valid and applicable instructional directive as the person’s own decision, and, for other decisions, must make the decision the person would have made using their values, preferences and prior statements. The role is separate from an enduring attorney under the Powers of Attorney Act 2014 (Vic) and from a support person, and it does not extend to compulsory mental-health treatment or to requesting or consenting to voluntary assisted dying on another person’s behalf. Disputes about capacity, appointments, directives or treatment decisions can be referred to the Office of the Public Advocate or determined by VCAT under the Act. Urgent legal advice may be needed where significant treatment is refused or where families or practitioners genuinely disagree. This article is general information about Victorian law as at 28 May 2026 and is not legal advice.

Contents

• Direct answer
• What is a medical treatment decision maker?
• When authority begins
• Decision-specific capacity
• Appointing a medical treatment decision maker
• Appointing several people and priority
• Signing, witnessing and electronic execution
• Revocation and replacement
• What happens if no appointment exists
• The statutory hierarchy
• The limits of “next of kin”
• Distinctions from other roles and documents
• What is medical treatment?
• Advance care directives
• The substitute decision-making process
• Refusing significant treatment
• Emergency treatment and palliative care
• Compulsory mental-health treatment
• Voluntary assisted dying
• Disputes and VCAT
• Authority-comparison reference table
• Appointment-versus-hierarchy reference table
• Directive reference table
• Treatment-category reference table
• Dispute-pathway reference table
• Appointment checklist
• Decision-making checklist
• Dispute-response checklist
• Worked examples
• Common mistakes
• Practical action plan
• When urgent legal advice is required
• Conclusion
• Frequently asked questions

What is a medical treatment decision maker?

A medical treatment decision maker is the person authorised under the Medical Treatment Planning and Decisions Act 2016 (Vic) to make medical treatment decisions for another adult when that adult lacks decision-making capacity for the particular treatment decision. The role exists to ensure that a Victorian adult who cannot decide for themselves still has a clearly identified decision maker whose authority is recognised by hospitals, doctors, ambulance services, residential aged care providers and other health practitioners.

The role is separate from an enduring attorney under the Powers of Attorney Act 2014 (Vic), which covers personal and financial matters. It is separate from a guardian appointed by VCAT under the Guardianship and Administration Act 2019 (Vic), unless the guardian’s appointment specifically confers medical treatment decision-making authority. It is separate from a support person, who supports the adult’s own decision-making but does not make substitute decisions. And it is distinct from an executor under a Will, who has no authority during the testator’s lifetime at all.

When authority begins

The medical treatment decision maker has no authority while the adult has decision-making capacity for the treatment decision. The role only comes into effect when the adult lacks capacity for the particular decision at the time it needs to be made. It ends as soon as the adult regains capacity for that decision. That may be a matter of hours after anaesthesia, days during a delirium, months during a recovery, or the balance of the person’s life in cases of severe permanent incapacity.

Because authority depends on the absence of capacity for the particular decision, the same person may be the decision maker for one decision on Monday and have no authority for a different decision the same afternoon, if the person has regained capacity for the second decision by then. Hospitals, aged care services and health practitioners are expected to assess capacity in relation to the actual decision that must be made, not to treat the person as globally incapable because of a diagnosis or because they lacked capacity earlier.

Decision-specific capacity

Capacity in Victoria is decision-specific and time-specific. The Act treats capacity as the current ability to understand information relevant to the decision, to retain that information to the extent necessary, to use or weigh the information as part of the decision-making process, and to communicate the decision in some way. A person may have capacity for one medical decision and not another. A person may have capacity in the morning and lose it in the afternoon. Practicable support must be provided — interpreters, communication aids, simple language, time, or a supportive presence — before a person is treated as lacking capacity.

Capacity is not established by diagnosis. Dementia, an intellectual disability, an acquired brain injury, a psychiatric condition or a communication difference does not, by itself, remove capacity. Nor does an unwise decision. Capacity may fluctuate, and where fluctuation is genuine the decision should be made, where practical, when capacity is present. Practitioners must apply the statutory test rather than an assumption based on appearance, age or condition, and authority returns to the person as soon as they regain capacity for the decision.

Appointing a medical treatment decision maker

A Victorian adult with decision-making capacity for the appointment may appoint one or more medical treatment decision makers using the current Department of Health approved form. The person must sign the form and the appointee must sign an acceptance of appointment acknowledging the role and its duties. The current form and instructions must be used; a defective appointment document may not be valid.

An appointee must be an adult who is willing to act, understands the role and is not disqualified under the Act. The Act excludes some categories of paid health-care provider from being appointed. A person is typically appointed because they know the adult well, understand their values and preferences, are geographically and practically available, and are able to communicate calmly with clinicians. Age, family standing and birth order are not the test; suitability is.

Appointing several people and priority

The Act permits an adult to appoint more than one medical treatment decision maker and to specify an order of priority. The Act operates on the basis that only one person acts as the medical treatment decision maker for a given decision — the first appointee in the specified priority order who is reasonably available, willing and able to make that decision. That structure avoids paralysis where several relatives disagree, but it also means the appointment must be drafted clearly so the priority order is unambiguous.

Multiple appointments should not be treated as creating a family committee. Where one appointee is overseas, uncontactable, unwell or unable to accept the responsibility of a particular decision, the next appointee in the order steps up. Discussing the appointment with each appointee in advance, storing copies in known places and telling the general practitioner and any regular treating specialists who has been appointed is how the priority order actually operates in a crisis.

Signing, witnessing and electronic execution

An appointment of medical treatment decision maker must be signed and witnessed in the way the Act and current form require. Witness eligibility rules apply, including a requirement that at least one witness is authorised to witness statutory declarations. The appointee must sign an acceptance in the form.

Electronic and remote execution of some Victorian planning documents has been permitted at different times under specific regulations. Because those permissions can change and are subject to conditions about the technology used, the parties involved and how the process is recorded, the current position should be confirmed against the current legislation and Department of Health guidance before relying on an electronic signature or remote witnessing for a medical treatment decision maker appointment. Wet-ink signing in the presence of an authorised witness remains the safest default where there is any doubt.

Revocation and replacement

An adult who has decision-making capacity for the revocation may revoke an appointment of medical treatment decision maker. The Act specifies how revocation is documented. In practice the safest approach is a signed written revocation on the current approved form or as provided by the Act, prompt notification of the former appointee, the general practitioner, any hospital or residential aged care service holding a copy, and replacement by a new appointment where one is intended. Old copies should be marked or destroyed to prevent an outdated appointment being relied on in an emergency.

Replacement is usually done by making a fresh appointment on the current form that revokes the earlier appointment expressly. Where appointees have changed relationship with the person — separation, estrangement, relocation overseas, ill health or loss of capacity themselves — the appointment should be reviewed and replaced. An out-of-date appointment is one of the most common causes of avoidable disputes.

What happens if no appointment exists

If there is no valid appointment covering the treatment decision, the Act identifies the medical treatment decision maker through a statutory hierarchy. The first person in the hierarchy who is reasonably available, willing and able to make the decision acts. “Willing and able” contemplates that a person in the hierarchy who does not wish to take the role, or who cannot practically do so, is passed over in favour of the next person. “Reasonably available” contemplates practicality in the actual clinical time frame — a relative who cannot be contacted in an urgent situation is not reasonably available for that decision.

The statutory hierarchy

The hierarchy in the Act starts with any guardian appointed by VCAT with authority to make the medical treatment decision. Where no such guardian is available, the hierarchy then identifies (subject to eligibility and the reasonably-available, willing-and-able test) the spouse or domestic partner, the person’s primary carer, and specified relatives such as adult children, parents and adult siblings. The exact hierarchy and any age or other priority rules within a category should be checked directly against the current authorised version of the Act before it is applied. A practitioner or family member who assumes a particular relative automatically has authority may be applying an incorrect version of the rules.

The limits of “next of kin”

“Next of kin” is a description that appears on many hospital forms and in general conversation. It is not the statutory office of medical treatment decision maker. A person named as next of kin has no medical treatment decision-making authority unless they are also an appointed medical treatment decision maker or the highest-priority person in the statutory hierarchy for the decision. Treating “next of kin” as the legal decision maker is a common source of error, particularly where the person named as next of kin is not in fact the highest-priority person under the Act.

Distinctions from other roles and documents

Several roles and documents are commonly confused with the medical treatment decision maker. An enduring attorney appointed under the Powers of Attorney Act 2014 (Vic) has authority in relation to personal and financial matters, but not medical treatment. A guardian appointed by VCAT has authority within the terms of the guardianship order — medical treatment authority is included only if the order provides for it. A support person supports the adult’s own decision-making with capacity and does not make substitute decisions. A primary carer may become the statutory decision maker in the absence of a higher-priority person, but not otherwise. A nominated contact person in a hospital or aged care record is a communication contact, not a decision maker. An executor named in a Will has no authority during the person’s lifetime. Each role is separate, and each is defined by its own legislation or document.

What is medical treatment?

The Act defines “medical treatment” broadly and treats different categories of treatment differently. Routine treatment (for example, treating a chest infection or ordinary dental work) is one category. Significant treatment involves more serious or invasive interventions and attracts additional process. Emergency treatment permits medical treatment to be provided in genuine emergencies where obtaining a decision from the decision maker in time is not practicable. Palliative care is treated as a specific category with its own rules. Dental treatment, medical research and other categories may also be regulated by the Act or related legislation. Because the definitions and thresholds are set by the current legislation and can be technical, the category of a particular treatment should be identified with clinical and, where needed, legal input.

Advance care directives

An advance care directive is a formal document made by an adult with decision-making capacity that records treatment instructions or values for future medical treatment. It comes into effect only when the person lacks capacity for the decision. The Act recognises two kinds of directive that may appear together in the same document: instructional directives and values directives.

An instructional directive consents to or refuses specified medical treatment in specified circumstances. Where the directive is valid under the Act and its terms apply to the actual decision, it operates as the person’s own decision and must be given effect by the treating team and the decision maker. That is a strong legal effect and reflects the fact that the adult made the decision with capacity in advance.

A values directive records the person’s values and preferences about medical treatment. It is not a specific treatment instruction and does not itself consent to or refuse any particular treatment. Instead, it guides the medical treatment decision maker in identifying the decision the person would have made. Both kinds of directive can be important, but they operate differently, and confusing the two is a common cause of disputes.

Directives may lose their applicability if circumstances have materially changed since the directive was made, or if the terms do not fit the actual clinical decision. Where there is genuine uncertainty about whether a directive applies, urgent advice and, if necessary, a VCAT application should be considered rather than a unilateral decision to disregard it.

The substitute decision-making process

Where the decision is made by the medical treatment decision maker rather than being determined by a valid instructional directive, the Act sets out the process that must be followed. In broad terms the decision maker must identify the decision the person would have made if they had decision-making capacity, informed by any relevant values directive, the person’s known values and preferences, and prior statements the person has made about their treatment. The decision maker must also take account of the clinical information given by the treating team, the likely benefits and risks of the proposed treatment, and any alternative treatments available.

Consultation with significant people in the person’s life is contemplated by the Act, but consultation is not the same as transferring authority. Only the medical treatment decision maker with authority for the decision may consent to or refuse the treatment. Family convenience is not the test, and the decision maker must be careful to separate the person’s values from the decision maker’s own preferences, beliefs or interests. The exact statutory formulation should be applied in each case.

Refusing significant treatment

Where a medical treatment decision maker refuses significant treatment the Act sets out specific process obligations, including notification to the Office of the Public Advocate under the section 62 notification process. The Public Advocate’s role is to provide independent oversight of significant-treatment refusals, not to make the treatment decision. Health-practitioner obligations continue to apply, and the refusal is not automatically invalid; the process is designed to protect the person, the decision maker and the treating team by adding an independent check.

Where a treating team disputes the refusal, an application to VCAT may follow. Urgent legal advice is often warranted at this point, particularly where the refusal is time-critical or where the family or the treating team is divided.

Emergency treatment and palliative care

The Act permits medical treatment to be provided in genuine emergencies where the person lacks capacity and it is not practicable to obtain a decision from the medical treatment decision maker in the available time, subject to the current statutory requirements and any applicable directive. Emergency treatment is not a general workaround for ordinary treatment disagreement, and clinical practice should not label a difficult conversation as an emergency to avoid engaging the decision maker.

Palliative care is treated as a specific category. The current operation of a decision maker’s authority in relation to palliative care measures — including the interaction with any valid advance care directive — should be identified against the current Act and clinical guidance in each case. General statements should not be substituted for a specific analysis where important palliative care decisions are being made.

Compulsory mental-health treatment

Compulsory mental-health treatment for a person subject to the compulsory regime under the Mental Health and Wellbeing Act 2022 (Vic) is governed by that Act, not by a medical treatment decision maker appointment. The Office of the Public Advocate has published guidance to this effect. The medical treatment decision maker does not consent to or refuse the compulsory mental-health treatment itself, although they may still be the decision maker for other medical treatment for the person (for example a general anaesthetic for a physical condition), subject to the interaction between the two Acts.

Voluntary assisted dying

Voluntary assisted dying under the Voluntary Assisted Dying Act 2017 (Vic) requires the person themselves to have current decision-making capacity throughout the process and to make the request personally. A substitute decision maker cannot request or consent to voluntary assisted dying on another person’s behalf, and an advance care directive cannot be used to trigger voluntary assisted dying at a later date once capacity has been lost. Any voluntary-assisted-dying questions require specific advice under that Act and are outside the scope of this article.

Disputes and VCAT

The Act contemplates disputes about a range of matters: whether the person has capacity for the decision, who has priority under the statutory hierarchy, whether an appointment is valid or has been revoked, whether an instructional or values directive applies, and whether a particular treatment decision should be made. Not every disagreement requires a hearing. Many disputes are resolved through discussion, a second opinion, a case conference, the health service’s patient-liaison process or engagement with the Office of the Public Advocate. Where a dispute cannot be resolved, VCAT has jurisdiction under the Act, including an urgent-application process for time-critical matters. Standing to apply, the possible orders and the interaction with the Public Advocate should be checked against the current Act and VCAT practice.

Authority-comparison reference table

Appointment-versus-hierarchy reference table

The following table sets out the general framework only. The exact priority order, eligibility conditions and operation of the “reasonably available, willing and able” test should be verified directly against the current authorised version of the Act.

Directive reference table

Treatment-category reference table

Dispute-pathway reference table

Appointment checklist

• Full legal names of the person and every appointee.
• Current contact details for each appointee.
• Confirmation that each appointee is eligible under the Act.
• Confirmation that each appointee is willing to act.
• Discussion of the role, its limits and the substitute decision-making standard.
• Discussion of the person’s values and treatment preferences.
• Clear appointment priority where more than one appointee is named.
• Named alternative appointees for realistic scenarios.
• Signing method identified — wet ink or, where currently permitted, electronic.
• Eligible witnesses identified in advance.
• Identity verification for the person and witnesses.
• Signed acceptance by each appointee.
• Records of any electronic or remote-witnessing process.
• Copies provided to each appointee.
• Copy provided to the general practitioner.
• Copy provided to any regular hospital or specialist.
• Copy stored with any advance care directive and support person appointment.
• Diary date to review after relationship, health or location changes.
• Any older appointment expressly revoked.
• Documents accessible in an emergency — not locked away where no one can find them.

Decision-making checklist

• Confirm the person lacks capacity for this particular decision.
• Identify who is the authorised medical treatment decision maker for this decision.
• Locate the original appointment document.
• Locate any advance care directive.
• Determine whether an instructional directive applies to the decision.
• Identify the person’s values and preferences.
• Consider prior statements the person has made.
• Obtain full treatment information from the treating team.
• Ask about benefits, risks and likely outcomes.
• Consider realistic alternative treatments.
• Consult appropriate significant people in the person’s life.
• Separate the person’s values from your own.
• Document reasons for the decision.
• Communicate the decision clearly to the treating team.
• Seek advice if significant treatment is being refused.
• Seek urgent review where authority or validity is disputed.

Dispute-response checklist

• Identify the proposed treatment and its category.
• Identify urgency and the realistic clinical timeframe.
• Confirm any capacity assessment and its basis.
• Obtain appointment documents and any VCAT orders.
• Identify the correct statutory hierarchy.
• Locate any advance care directive.
• Record the competing positions in writing.
• Obtain contemporaneous medical evidence.
• Preserve communications from all parties.
• Identify the current risks of proceeding or not proceeding.
• Contact the health service’s legal or patient-liaison process where appropriate.
• Consider notifying or engaging the Office of the Public Advocate.
• Consider a VCAT application, including the urgent process where warranted.
• Avoid unauthorised treatment directions or self-help outside authority.
• Obtain urgent legal advice at an early stage.

Worked examples

Each of the following examples is illustrative only. It does not describe an actual case or guarantee any particular outcome.

1. Spouse formally appointed. An older adult appoints their spouse as the medical treatment decision maker with an adult child as alternative. When the adult undergoes emergency surgery, the spouse readily acts as decision maker for the follow-up decisions during recovery.
2. Several appointees listed in order. An adult appoints their spouse, then an adult child, then a sibling. During a period of the spouse’s own ill health the adult child steps up as the first reasonably available appointee, without the need for any application.
3. First appointee overseas and unavailable. The first-priority appointee is uncontactable while overseas when an urgent decision is required. The next appointee in the specified order acts.
4. No formal appointment. An adult loses capacity after a stroke without ever making an appointment. The statutory hierarchy is applied and the spouse is identified as the medical treatment decision maker for the decision.
5. Family disagreement about hierarchy. Adult children disagree about who has priority. The hierarchy under the current Act is checked and only one person is identified as the decision maker for the decision; the others may still be consulted but they do not vote.
6. Adult child mistakenly claims authority as “next of kin”. An adult child listed as “next of kin” on a hospital form assumes they may consent to surgery, but a spouse with priority under the hierarchy is available. The spouse is the correct decision maker.
7. Enduring attorney assumes medical authority. A person appointed under an enduring power of attorney (for personal and financial matters) attempts to consent to a general anaesthetic. That role does not confer medical treatment authority; the medical treatment decision maker (appointed or under the hierarchy) is the correct decision maker.
8. Support person mistaken for decision maker. A support person, appointed to help the person communicate with clinicians while the person had capacity, is asked by a hospital to consent to treatment after the person loses capacity. The support person has no substitute authority.
9. Temporary unconsciousness after surgery. The person cannot communicate during the immediate postoperative period. The medical treatment decision maker makes decisions during that period; once the person regains capacity, decision-making returns to them.
10. Fluctuating dementia capacity. A person with dementia has good days and bad days. Where a non-urgent decision can be made when capacity is present, it is, and the decision maker does not act. On days when capacity is absent for the decision, the decision maker acts.
11. Instructional directive refusing a treatment. A valid instructional directive refuses a specified treatment in specified circumstances. When those circumstances arise, the directive operates as the person’s own decision and must be followed.
12. Broad values directive requiring interpretation. A values directive expresses a general preference for comfort-focused care. It is not a specific instruction. The decision maker uses it, alongside the person’s known values, to identify the decision the person would have made.
13. Family asks for treatment contrary to the person’s directive. Family members want a treatment that the person’s valid instructional directive refuses. The directive prevails; the family disagreement does not override it.
14. Decision maker’s religious views differ. The appointed decision maker holds views that differ from the person’s. The decision maker must set aside their own views and identify the decision the person would have made.
15. Refusal of significant treatment. The medical treatment decision maker refuses a significant treatment. The section 62 notification to the Office of the Public Advocate is made and the treating team continues to engage the decision maker while the process operates.
16. Urgent emergency treatment. A person is brought in unconscious after an accident and requires immediate treatment to prevent death or serious harm. The current Act permits emergency treatment where obtaining a decision from the decision maker in time is not practicable, subject to any applicable directive.
17. Palliative care dispute. A family disagrees about specific palliative measures. The decision maker’s authority and any applicable directive are identified against the current Act rather than being decided by consensus.
18. Guardian appointed by VCAT. VCAT has appointed a guardian with authority for medical treatment decisions. The guardian is the medical treatment decision maker within the terms of the order.
19. Compulsory mental-health treatment. A person subject to compulsory mental-health treatment under the Mental Health and Wellbeing Act 2022 (Vic) develops a physical condition requiring surgery. The medical treatment decision maker may act for the surgery decision, but does not consent to or refuse the compulsory mental-health treatment itself.
20. Disagreement about whether an appointment was revoked. A family member claims the person revoked the appointment before losing capacity, but there is no signed revocation. The dispute may be referred to VCAT.
21. Alleged pressure in making an appointment. There are allegations that the person was pressured into appointing a particular decision maker. VCAT may determine whether the appointment is valid on the evidence.
22. Hospital cannot locate the document. The person has made an appointment but no copy is available at the hospital in an emergency. Contemporary practice, statutory declarations and prompt production of the original document may still allow the appointment to be relied on; storing copies with the general practitioner and any regular hospital in advance is safer.
23. Person regains capacity. After a delirium resolves, the person regains capacity for the treatment decision. The medical treatment decision maker’s authority for that decision ends and the person decides for themselves.
24. VCAT application about disputed authority. A serious dispute about the identity of the decision maker cannot be resolved between the family and the treating team. VCAT is asked to determine the question, with medical and appointment evidence and, where warranted, on an urgent basis.

Common mistakes

• Relying on the phrase “next of kin” as if it were the legal role.
• Assuming an enduring attorney has automatic medical treatment authority.
• Failing to make a formal appointment at all.
• Failing to appoint alternative decision makers.
• Treating several appointees as a committee that must vote.
• Not asking whether the proposed appointee is willing to act.
• Failing to discuss values and treatment preferences with the appointee.
• Losing the original appointment document.
• Failing to provide copies to the general practitioner, hospital and residential aged care service.
• Assuming a diagnosis of dementia or disability equals incapacity for every decision.
• Ignoring the decision-specific nature of capacity.
• Treating a support person as a substitute decision maker.
• Ignoring a valid instructional directive.
• Treating a values directive as if it were an exact treatment instruction.
• Substituting the decision maker’s own values for the person’s.
• Failing to document the decision-making process.
• Refusing significant treatment without engaging the section 62 process.
• Assuming family agreement cures a lack of statutory authority.
• Delaying urgent VCAT advice where a genuine dispute exists.
• Assuming authority continues after the person regains capacity.
• Attempting to consent to compulsory mental-health treatment or voluntary assisted dying outside the role.

Practical action plan

1. Identify whether the person currently has decision-making capacity.
2. Decide whether a formal appointment is needed now or should be made before capacity is affected.
3. Select a willing and suitable person as the primary appointee.
4. Choose one or more alternative appointees.
5. Discuss values, preferences and treatment expectations openly.
6. Consider making an advance care directive alongside the appointment.
7. Complete the current approved appointment form carefully.
8. Follow the current signing and witnessing requirements exactly.
9. Record the appointee’s acceptance in the form.
10. Revoke or replace any inconsistent older appointment expressly.
11. Distribute copies to each appointee, the general practitioner, hospital and residential aged care service.
12. Tell relevant family members who has been appointed and why.
13. Review the appointment after relationship, health or location changes.
14. When acting, confirm your authority for each specific decision.
15. Locate and apply any advance care directive.
16. Follow the statutory substitute decision-making process rather than a generic “best interests” test.
17. Document the reasons for each significant decision.
18. Seek advice on any significant-treatment refusal before it is finalised.
19. Consider VCAT where capacity, priority, validity or treatment is genuinely disputed.

When urgent legal advice is required

Urgent legal advice is warranted where significant treatment is being refused, where there is a real dispute about capacity, priority, appointment validity or a directive, where allegations of pressure or improper motive are raised, where an urgent VCAT application appears necessary, or where a treating team is proceeding contrary to what the decision maker considers to be the person’s valid instruction. For general advice on appointing or acting as a medical treatment decision maker, see our Wills & Estate Planning service page or the profile of our reviewer, Julian McIntyre.

Conclusion

The medical treatment decision maker role in Victoria is a distinct statutory office. It arises only when the person lacks decision-making capacity for the particular medical treatment decision. It may be filled by a person the adult formally appoints, or, in the absence of an appointment, through the statutory hierarchy under the Medical Treatment Planning and Decisions Act 2016 (Vic). It is separate from an enduring attorney, from a guardian, from a support person and from any informal “next of kin” expectation. Its exercise is guided by any valid and applicable advance care directive and by the person’s values and preferences, not by family convenience or the decision maker’s own views. Refusal of significant treatment engages a specific process involving the Office of the Public Advocate, and disputes about capacity, authority, directives and treatment may be referred to VCAT. Taking the time to appoint the right person, to record values and preferences, to distribute the document and to review it periodically is one of the most practical ways a Victorian adult can protect their own future medical treatment. This article is general information about Victorian law as at 28 May 2026 and is not legal advice. Advice from a Victorian solicitor tailored to the actual circumstances should be obtained before any appointment is made, revoked, replaced or challenged.

Frequently Asked Questions