By Tracy Collins & Morgan Collens

In matters of medical care, especially during critical situation where an individual may be unable to communicate their preferences, having clear directives in place is essential. Two common mechanisms exist for this purpose: appointing a medical treatment decision maker and creating an advance care directive. While both serve the purpose of ensuring that person’s wishes regarding medical treatment are upheld, they differ in their scope and legal implications.


Medical Treatment Decision Maker

A Medical Treatment Decision Maker is an individual chosen by you to make medical decisions on your behalf in case you become incapacitated due to illness or injury. This role carries significant responsibility and should be assigned to someone who you trust to respect your values and preferences.

Key Characteristics:

  1. Legal Authority: A medical treatment decision maker has the legal authority to make decisions regarding your medical treatment if you are unable to do so yourself.
  2. Trust and Understanding: The chosen individual should have a clear understanding of your values, beliefs, and treatment preferences. This ensures that the decisions made align closely with your wishes.
  3. Support Person: Additionally, the individual can appoint a support person to assist in making, communicating, and implementing medical treatment decisions. However, unlike the medical treatment decision maker, a support person does not possess legal authority to make decisions on behalf of the individual.


Advance Care Directive

An Advance Care Directive is a legal document that allows you to outline your preferences for medical treatment, ensuring your wishes are known and respected in the event you cannot communicate your decisions. It provides guidance to health professionals and the appointed medical treatment decision maker regarding your treatment preferences.

Key Characteristics:

  1. Values Directive: This part of the directive captures your overarching values and preferences regarding medical care. It serves as a guide for your medical treatment decision maker, helping them understand your overall healthcare philosophy.
  2. Instructional Directive: This contains legally binding statements dictating specific medical treatments you do or do not consent to in various scenarios. For instance, you may specify preferences regarding life-sustaining treatments or palliative care.


Key Differences

Legal Authority:

The primary distinction between a medical treatment decision maker and an advance care directive lies in legal authority While a medical treatment decision maker can make decisions on your behalf, an advance care directive provides guidelines and instructions for healthcare professionals and the decision maker but does not grant decision-making authority.

Scope of Influence:

A medical treatment decision maker can make real-time decisions based on your current medical condition, whereas an advance care directive primarily focuses on guiding future medical decisions based on predetermined preferences.

Who Creates the Document:

Your lawyer can assist you with creating an Appointment of Medical Treatment Decision Maker when drafting all other documents relating to your overall estate plan, such as your Will or Enduring Power of Attorney. This is then signed by you in front of two adult witnesses and must be accepted by the person you have appointed.

Your doctor can assist you with creating your Advance Care Directive. To make a valid advance care directive you need to sign in front of two witnesses. One must be a registered medical practitioner (a medical doctor). Neither witness can be someone you have appointed as your medical treatment decision maker.

Both appointing a medical treatment decision maker and creating an advance care directive are crucial steps in ensuring that an individual’s wishes regarding medical treatment are honored, especially when they are unable to communicate their preferences. While a medical treatment decision maker holds legal authority to make decisions, an advance care directive serves as a comprehensive guide for healthcare providers and the decision maker. By understanding the difference between these two mechanisms, individuals can take proactive steps to assert control over their medical care, even in challenging circumstances.


Disclaimer: This publication contains comments of a general and introductory nature only and is provided as an information service. It is not intended to be relied upon as, nor is it a substitute for specific professional legal advice. You should always speak to us and obtain legal advice before taking any action relating to matters raised in this publication.