Guardianship, Power of Attorney and Advanced Care
directives
What is the difference between a
Guardian and a Power of Attorney?
A Guardian is a person
empowered by the Guardianship Board to make decisions about care and
treatment for a person considered to be in need of a guardian. Alternatively
a person may have appointed an enduring guardian while they were
still capable of doing so (see below) A guardian may also
make other decisions for an incapacitated person.
Power of Attorney achieves the same purpose in relation to
financial and property matters. However, a power of attorney may not
authorise the person to make treatment and care decisions.
Who is a Person in Need of a Guardian?
A person in need of a guardian is any one over 16years of age
incapable of making their own decisions because of a mental or
physical disability impacting on their capacity. Capacity refers to
a person’s ability to make decisions. Legally, this involves
understanding, interpreting, weighing up and deciding a course of
action on the information provided. A person may be sick or ill,
either mentally or physically, but still have the requisite capacity
to decide on treatment and care options. The law supports a persons
own decision making capacity as much as possible and the right of
self determination is a prime consideration for the operation of the
Guardianship Act. Self determination is very important and it is a
very big step to award this right to someone else.
Guardianship Process
If a person has not appointed an enduring guardian and becomes
incapable making decisions themselves, Guardianship can be bestowed
on a person over 18 years old following application to act for the
person in need of a guardian. This is a formal process requiring
application to the Guardianship Board. It can be made by anyone who
is genuinely concerned with the person’s welfare. The application
must specify the grounds for the application or why the person in
need of a guardian is considered to be in need.
Without an appointed guardian treatment and care decisions can
still be made by a ‘person responsible’ if the person is incapable
of making their own decisions. ‘Persons responsible’ are set out in
the Guardianship Act and therefore have legal authority. These
persons are ranked in a hierarchy which follows family lines. Recent
changes enable same sex partners to be considered with other family
members in the hierarchy.
Guardianship orders appointing a guardian can be appealed and/ or
reviewed. The matters a guardian has the ability to decide for the
person requiring the guardian can also be limited and the timeframe
of the guardianship order can also be limited.
Enduring Guardian
Adults may appoint an Enduring Guardian. An enduring guardian is
able to act for the person in the future if they become
incapacitated. The person can appoint an enduring guardian ahead of
time so that they are able to instruct the person about treatment
and care options to pursue in case they become incapacitated. This
person then becomes their substitute decision maker. The enduring
guardian can make decisions and give consent to medical and dental
treatments, about the persons living arrangements and other
important decisions.
Advanced Care Directives
Advanced directives or living wills, as they are also called, are
directives in regard to the treatment and care people wish to
receive after they have become incapacitated. These directives are
not legally binding but they are persuasive in a court or a tribunal
which may be being asked to determine the validity of a proposed
treatment or the withholding of care or treatment for a patient. If
the person has specified ahead of time what their wishes are under
particular circumstances then the law will respect those wishes.
Once again the right of a person to determine what is done to
them is upheld strongly under the law. The right of self
determination is usually well respected by health care
practitioners. It is increasingly common place for these issues to
be raised with people prior to the initiation of treatment or on
admission to hospital. People are encouraged more so than ever to
express their wishes in regard to ongoing treatments while they are
still able in case they become incapacitated and the treatment
decisions may then be made by someone else.
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