LGBTI Advance Care Planning

Page last updated: 22 June 2017
A factsheet covering an overview of LGBTI advance care planning issues.
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LGBTI Advance Care Planning

An Advance Care Plan or Advance Care Directive enables a person to document their healthcare wishes, have their values respected and ensure they receive the end of life healthcare they choose should they be unable to instruct medical professionals at that time. 

Advance care planning will also help a person’s family, loved ones, treating doctors, healthcare team and aged care providers to make the right decisions.

When making an advance care plan, a person can choose to appoint a substitute decision-maker who can speak on their behalf if needed.  A substitute decision-maker should respect the person’s healthcare choices and be prepared to communicate clearly and confidently when talking to doctors, other health professionals, family members and aged care providers.  Substitute decision-makers can also be referred to as:

  • an enduring guardian;
  • an enduring power of attorney;
  • an agent; or
  • a decision-maker. 

In Australia, each state and territory has different approaches to advance care planning.  Information on arrangements in each state and territory is available on the Advance Care Planning Australia website.

Some LGBTI people are not in close contact with their biological family, have no children, or have children who do not accept their life decisions.  These factors can impact on their healthcare at critical times in their lives.  The living arrangements, domestic partnerships and friendship groups of LGBTI people may not be recognised by end-of-life, medical guardianship and relevant financial legislation arrangements.  

In the absence of a LGBTI person nominating a specific person or people to make decisions for them when they are unable, or expressing their wishes themselves, the law provides a default list of the types of people it will recognise to make decisions on a the LGBTI person’s behalf when they are unable. This will usually be a legal spouse, followed by any children, followed by certain closely related family members. If an LGBTI person does not publicly recognise their partner, the law may and some states will recognise the LGBTI person’s children and/or family members ahead of their partner and friends. 

To address this issue, a growing number of LGBTI people are setting up advance care plans and advance care directives.

An enacted advance care plan and advance care directive allows LGBTI people to:

  • record the medical treatment they would like to receive, letting their loved ones and healthcare providers know their wishes in advance; 
  • name other trusted and respected people to make decisions for them if they are unable to do so; and
  • identify people they do not wish to be involved in making decisions on their behalf. 

For more information on palliative care, advance care planning and available support, please see:

Advance Care Planning Australia web site

My Aged Care – End of life - Advanced Care Planning

Palliative Care - Advance Care Planning