A daughter’s experience caring for her father during his final days in a hospital on Queensland’s Sunshine Coast underscores the value of advance health directives in guiding medical decisions at end of life. The father, who had signed a legally binding advance health directive after his 2005 prostate cancer diagnosis, had clearly documented his wish to avoid life-sustaining treatments including cardiopulmonary resuscitation, assisted ventilation, and artificial nutrition, preferring instead comfort-focused palliative care. His written wishes provided clarity for his family during a 12-day period when he remained unconscious and unable to communicate.
According to a 2025 study by Advance Care Planning Australia, only 33% of Australians have undertaken advance planning, with just 6% formally completing an advance care directive. Without such documentation, families frequently face conflict over treatment decisions. Associate Professor Davinia Seah, head of palliative medicine at St Vincent’s hospital in Sydney, describes situations where family members disagree about whether to pursue aggressive interventionist care or comfort-focused approaches, leaving clinicians unable to determine whose wishes should guide medical decisions. Seah notes that family dynamics often reflect broader relationship patterns, and that having written documentation is essential when families cannot agree.
Clinicians also face challenges when directives exist but are inaccessible, such as when paperwork is held by solicitors rather than available at the hospital. When no documentation or legally appointed guardian exists, doctors must assess whether well-meaning supporters truly represent a patient’s interests.
John Groves, a New South Wales retiree with cardiomyopathy, completed an advance care directive after multiple health crises left him facing uncertain outcomes. His documented wishes address both medical interventions and personal values, specifying that he wishes to die at home if possible, remain pain-free, accept CPR but decline dialysis and life-prolonging drug treatments, and donate organs after death. Beyond medical preferences, advance care directives typically allow individuals to articulate values relevant to end-of-life care, such as whether flowers, music, or garden time matter to their quality of life. Seah describes patients documenting that activities like eating chocolate, golfing, or maintaining independence define what makes life worth living—information that helps guide compassionate medical decisions.
The author concludes by recognizing the gaps in her own end-of-life planning and taking steps to complete her own advance care directive, reflecting a broader call for Australians to engage in this planning process before medical crises arise.
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