Ethics, advance care planning and respecting patient wishes
The four principles applied at the end of life, beneficence versus non-maleficence, advance care planning and advance care directives in Australian law, substituted judgement, advocacy, cultural safety for Aboriginal and Torres Strait Islander and Māori families, organ donation, and how voluntary assisted dying fits alongside palliative care in 2026.
Tier 1Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- At the end of life the core tension is beneficence versus non-maleficence: will this treatment give the person more than it takes away, given their prognosis and goals?
- Advance care planning (ACP) is a process of conversations. An advance care directive (ACD) is the signed document that may result. A valid, applicable refusal in an ACD binds clinicians in every Australian state and territory, though Queensland limits when a refusal of life-sustaining measures operates (see below).
- When a person can't decide, the substitute decision-maker decides as the person would have, not as they themselves would choose.
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Sources
- National Consensus Statement: Essential elements for safe and high-quality end-of-life care (2nd edition)AU/NZAustralian Commission on Safety and Quality in Health Care, 2023
- National Framework for Advance Care Planning DocumentsAU/NZAustralian Government Department of Health, 2021 (replaced the 2011 National Framework for Advance Care Directives)
- Advance Care Planning Australia - law and ethics by state and territoryAU/NZAdvance Care Planning Australia (Austin Health)
- Therapeutic Guidelines: Palliative Care, version 5 (Decision-making and ethical challenges in palliative care)AU/NZTherapeutic Guidelines Limited, 2024 (version 5, December 2024)
- Good medical practice: a code of conduct for doctors in Australia (section 4.13, end-of-life care)AU/NZMedical Board of Australia, In effect from 1 October 2020
- Voluntary assisted dying: upcoming changes to the Victorian Act (commencing 19 April 2027)AU/NZVictorian Department of Health, Amendments passed 18 November 2025
- ANZCOR Guidance Statement 10.5.3: Legal and ethical issues related to resuscitation - withholding and withdrawal of resuscitationAU/NZAustralian and New Zealand Committee on Resuscitation, Current at November 2026
- Detering KM et al. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010;340:c1345AU/NZBMJ, 2010
- Te Ara Whakapiri: Principles and guidance for the last days of life (2nd edition)AU/NZMinistry of Health, New Zealand, 2017
- End of Life Choice Act 2019 (NZ)AU/NZNew Zealand Parliamentary Counsel Office, In force 7 November 2021
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback