Australian Capital Territory Repealed Acts

This legislation has been repealed.

MEDICAL TREATMENT ACT 1994 (REPEALED) - SCHEDULE 1

Schedule 1    

(see s 7)

Form 1     Written direction under Medical Treatment Act 1994

IMPORTANT NOTICE:

If you have previously given a power of attorney under the Powers of Attorney Act 1956, that power might be affected by filling out this form. You should note that the power to make decisions relating to the withholding or withdrawal of medical treatment will now be exercised according to your instructions on this form and not the form you previously filled in under the Powers of Attorney Act 1956.

If you give a power of attorney under the Powers of Attorney Act 1956 after you have filled in this form, this form will no longer have any effect.

1.     I, (name) of (address) DIRECT that—

    *(a)     medical treatment generally be withheld or withdrawn; or

    *(b)     medical treatment, being (specify particular kind of medical treatment) , be withheld or withdrawn.

2.     I REVOKE all other directions previously made by me under the Medical Treatment Act 1994 .

3.     I CERTIFY that this direction is made voluntarily and without inducement or compulsion.

4.     I CERTIFY that I am of sound mind and have attained the age of 18 years.

Dated:    

Signature of person making the direction (or of another person signing in the presence of and by the direction of the maker of the direction)

Dated:    

Signature of witness

Dated:    

Signature of witness

*Delete whichever is not applicable

Form 2     Power of attorney under Medical Treatment Act 1994

(see s 13)

IMPORTANT NOTICE:

This form will allow your chosen attorney (who must be over 18) to make certain medical decisions for you if you become incapable of making those decisions yourself.

This form allows your attorney to make decisions about withholding or withdrawing medical treatment. You can provide that this is to include medical treatment generally, or you can specify a particular kind of treatment which you wish to be withheld or withdrawn.

To create a power of attorney this form must be signed and dated either by you or by another person you have asked to sign and date the form for you. If you ask another person to sign and date this form for you, they should do so in your presence. You must also have two (2) witnesses sign the form. The person to whom you are giving the power of attorney, or any of that person's relatives, cannot be witnesses.

If you have previously given a power of attorney under the Powers of Attorney Act 1956, that power might be affected by filling out this form. You should note that the power to make decisions relating to the withholding or withdrawal of medical treatment will now be exercised according to your instructions on this form and not the form you previously filled in under the Powers of Attorney Act 1956.

If you give a power of attorney under the Powers of Attorney Act 1956 after you have filled in this form, this form will no longer have any effect.

Before signing this form, you should read it carefully.

1.     I, (name of grantor) of (address) APPOINT (name of grantee) of (address) to be my attorney for the purposes of the Medical Treatment Act 1994 .

2.     I AUTHORISE my attorney, if I become incapacitated, to request that—

    *(a)     medical treatment generally be withheld or withdrawn; or

    *(b)     medical treatment, being (specify particular kind of medical treatment) , be withheld or withdrawn;

if he or she believes on reasonable grounds that, if I were capable of making a rational judgment and were to give serious consideration to my health and wellbeing, I would make that request.

3.     I REVOKE all other powers of attorney previously granted by me under the Medical Treatment Act 1994 .

4.     I CERTIFY that I am of sound mind and have attained the age of 18 years.

Dated:    

    Signature of person giving the power (or of another person signing in the presence of and by the direction of the person giving the power)

Dated:    

Signature of witness [ not related to the grantee ]

Dated:    

Signature of witness [ not related to the grantee ]

ACCEPTANCE BY GRANTEE

I have read this power of attorney. I understand that by signing this document, I take on the responsibility of exercising the powers which I have been given by the document. I also understand that I must exercise these powers in accordance with the Medical Treatment Act 1994 .

Dated:    

Signature of grantee

*Delete whichever is not applicable