Limits of the Act and instruments created under the Act
The refusal of treatment certificate ceases to operate once the circumstances that gave rise to it are no longer relevant. The refusal of treatment certificate applies only to a current condition and not to a condition that may or may not occur in the future.
For this reason, the refusal of treatment certificate does not function as an "advance directive" except where the treatment is anticipated for a current condition.
The refusal of medical treatment does not cover medical procedures or other procedures that would be considered palliative care. Palliative care includes reasonable treatment for the relief of pain, suffering or discomfort and the reasonable provision of food and water. Palliative care does not include artificial feeding through a PEG (percutaneous endoscopic gastrostomy) tube inserted directly into the stomach.
When a person cancels a certificate or their medical condition has changed to such an extent that the specific or general provisions in it no longer apply, the refusal of medical treatment certificate is no longer in force.
The enduring power of attorney (medical treatment) does not allow an agent to make decisions about a person's affairs other than those about medical treatment. A general power of attorney, an enduring power of guardianship and an enduring power of attorney (financial) are all created and administered by other laws.
An enduring power of attorney (medical treatment) does not come into effect until the person is no longer able to make their own decision. A person retains the responsibility to make their own decisions if they are able to do so.
An agent can only refuse medical treatment on behalf of a person when the medical treatment would cause unreasonable distress to the person or they believe that the person, if they were still competent, would refuse the treatment.