Substitute Decision Makers

Someone to speak on your behalf

Substitute (Noun): One that takes the place of another; a replacement



Why we all should choose someone to speak for us

"A fundamental principle of health law is an adult’s right to decide what is or is not done to their bodies. This includes the right to consent to or refuse medical treatment. An adult who has capacity can choose to refuse medical treatment even if failure to receive treatment will result in death."

Substitute decision makers for health and lifestyle

Legally appointed decision makers

This is a legal appointment or one or multiple people using a prescribed form and an option to add conditions like "this is only where my spouse is not available" that allows you to legally appoint someone you want to be able to give or withhold consent for medical treatment and care only when you're not able to make or communicate decisions yourself.

Their decisions must be in line with your preferences and wishes as outlined in your Advance Care Plan or Directive; if you have one.

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Person responsible

When no SDM has been appointed by the you or by the Court or Guardianship Board, the treating medical practitioner will seek to identify someone according to the hierarchy set out by the rules of the state or territory. 

This is not an on-going role as the law in most states/territories specifies that the Person Responsible is the first person in the hierarchy who is ‘readily available’– the same person may not be available each time a decision is needed.

It's good to note that your Person Responsible cannot:

  • make decisions about your finances, accommodation or support
  • consent to treatment if you object
  • consent to certain treatments, including sterilisation or experimental treatments.

The names and rules will depend on where you live - our Substitute Decision Maker tool guides you to identify who the right people are for you. 

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A substitute decision maker is a person who makes a health care or medical treatment decision for a person who has lost decision-making capacity.

Losing decision-making capacity can be temporary or permanent and is usually caused by illness, injury or the effects of alcohol, drugs or medication.

Not to be confused with

Supported decision making

Supported decision-making involves a person supporting another person, such as an adult with a cognitive impairment, to make their own decisions. This differs from substitute decision-making, where a decision is made for the person by a substitute decision-maker.

Victoria and Queensland are the only Australian States and Territories that have laws on supported decision-making.

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Enduring Power of Attorney

An Enduring Power of Attorney (commonly known as an EPA) is a legal document a person can make that gives another person/s, or organisation, the legal authority to make financial and/or property decisions on their behalf.

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Make it easy for heath professionals to know who can speak for you.

Doctors tell stories of family disputes when it comes to verifying who can speak on their patients behalf when their patient is unconscious or unable to communicate for another reason.

Knowing who can speak on your behalf can avoid a lot of stress, arguments and unwanted medical interventions.

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PLEASE NOTE: Our advice should be considered general in nature. We do not provide any legal, tax, medical or other professional advice and would advise that you seek expert professional or medical advice before making any decisions based on your individual circumstances. 

NEXT: Advance Care Planning

Choosing and nominating your substitute decision maker(s) is part of the advance care planning process. 

Find out more and why we should all start while we're young and healthy in our advance care planning section

Advance Care Planning information >