Brown Margaret
Adjunct Research Fellow, University of South Australia.
J Law Med. 2018 Feb;25(2):538-548.
This article analyses how the Advance Care Directives Act 2013 SA is changing the decision-making paradigm in health care and guardianship in South Australia. It examines the background to the legislation, the main areas that have been transformed by the Act and the amendments to associated legislation. The significant changes include an increased respect for autonomy and a presumption of decision-making capacity, a new paradigm of substitute decision-making, clarification of the decision-making hierarchy, and protections for medical practitioners who decline to give treatment that would have no benefit to a dying patient. Despite some difficulties implementing the new scheme, this article argues that the Act has introduced important changes and clarifications in the law that other States would do well to follow. When it is fully implemented, the Act will ensure that the wishes of patients are respected and that doctors can follow these wishes without fear of prosecution.
本文分析了南澳大利亚州2013年的《预先医疗指示法案》如何改变该州医疗保健和监护方面的决策模式。它审视了该立法的背景、该法案带来变革的主要领域以及相关立法的修正案。重大变化包括对自主权的更多尊重和决策能力的推定、替代决策的新模式、决策层级的明确以及对拒绝给予对濒死患者无益处治疗的医生的保护。尽管在实施新方案时存在一些困难，但本文认为该法案在法律上引入了重要变革和明确规定，其他州不妨效仿。该法案全面实施后，将确保患者的意愿得到尊重，医生能够遵循这些意愿而不必担心被起诉。
