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Advance Care Directive — RACP Adult Medicine MCQ

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ModerateGeriatric MedicineAdvance Care DirectiveRACP Adult Medicine

An 80-year-old woman with advanced dementia is admitted with community-acquired pneumonia. Her daughter requests 'everything be done'. The patient has a valid advance care directive stating she does not want invasive ventilation, CPR, or ICU admission. Her daughter claims the ACD is outdated. According to Australian law, what takes precedence?

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Correct answer: A — The patient's valid advance care directive

In Australia, a valid advance care directive (ACD) is legally binding and takes precedence over family wishes and clinician preferences. It represents the patient's autonomous decision made when they had capacity. Even if the family disagrees, the ACD must be followed. If there is doubt about the ACD's validity or currency, the treating team should seek legal advice, but a valid ACD cannot be overridden by a substitute decision-maker's contrary wishes.

Reference: Australian Health Ministers Advisory Council – 2011 – National ACP Framework; State-based ACD Legislation