Supported Decision Making
Before making a decision for the person, a health care decision maker should try their best to help the person make their own decision, using any available support suitable for the situation.
How to make health care decisions
Support to assist the person in making the health care decision could include:
- Using information, technology or formats tailored to the particular needs of the person.
- Access to a language or Auslan interpreter.
- Using modified language, visual aids or other means.
- Communicating or assisting the person to communicate the person's decision.
- Giving the person additional time and discussing the matter with the person.
If the person is not able to make their own decision with support, a health care decision maker must follow the below steps in order.
The Health Care Decision Making Act 2023 includes rules about how health care decisions must be made for other people. These are called the health care decision making principles.
A health care decision maker helps the person to make their own decisions. If the person cannot make a decision with help, the below steps should be followed in order before moving on to the next.
Follow the person's 'Advance Care Statement'
If the person has an 'Advance Care Statement' in their Advance Personal Plan that relates to the health care decision needed, then the person's wishes in this statement must be followed.
Make a decision the person would have wanted
If the person does not have an 'Advance Care Statement', the health care decision maker must make the decision that the person would have wanted. (Even if it is not in their best interest).
Make a decision in their 'best interests'
If the health care decision maker does not know what the person would have wanted they must make a decision in the person's 'best interest'.
Refer to our guideline Making health care decisions PDF (2.1 MB) for more information.
Decisions a health care decision maker can make
Health care decisions makers cannot make decisions about all types of health care in all circumstances.
Health care decisions are made at the time the health care decision is needed and could be for a single treatment or as a course of health care to be provided over a period of time.
Health care decisions makers do not have authority to consent to:
- restrictive practices (there are certain exceptions to this. Refer to the NT Health website for further information)
- restricted health care (this requires an application to NTCAT).
Restricted health care includes:
- sterilisation*
- termination of a pregnancy*
- removal of non-regenerative tissue
- special medical research or experimental health care
- health care not yet accepted as evidence-based
- electroconvulsive therapy
- treatment involving adverse stimulus.
If a health care decision maker is not available, the health care provider can provide the health care without consent only in the following circumstances:
- The health care is 'routine' - when the person is not objecting to health care that does not cause significant intrusion, risks, side effects, pain or distress including personal care and grooming.
- An emergency - when the person needs to be treated urgently to save their life or prevent them from serious damage to their health, or significant pain or distress.
- Relief from pain and distress - in the context of palliative care and preventing a person from needlessly suffering. A decision to stop active treatment and progress to a palliative care plan is made by the health care decision maker, in consultation with the treating team. However, a health care decision maker cannot refuse health care that would prevent unnecessary pain or suffering to the person.