Substitute decision-
maker for Jack

| PART 2 |

Substitute decision-maker for Jack

Jack is admitted under the geriatrics team.

Later that same day, the emergency specialist reviews Jack and liaises with the geriatric registrar to admit Jack under geriatrics. The prescribed plan of care for Jack in the aged care ward is for a short stay of 72 hours involving IV rehydration, improved nutritional intake, bloods for pathology testing, and vital signs monitoring.

Coral claims she is the ‘person responsible’ for substitute consent. Meanwhile Jack’s son, who is Coral’s brother, has called from interstate to say that he thinks Coral bullies Jack and hospital staff should not listen to her.

As the eldest child, he believes he should be the ‘person responsible’ for healthcare decisions relating to Jack.

Identifying a ‘Person Responsible’

All jurisdictions in Australia (apart from the Northern Territory) have passed legislation to authorise certain relatives and close friends to provide substitute consent to treatment. In general, the legislation establishes a hierarchical ranking of persons in order of who can be approached for substitute consent.

Drag and drop the following substitute consent providers in order of hierarchy (in NSW)

A spouse, de-facto spouse or partner where there is a close continuing relationship
An appointed guardian (or enduring guardian) who has been given the function to consent to medical and dental treatments
A friend or relative who has a close personal relationship, frequent personal contact and a personal interest in the person’s welfare, on an unpaid basis
An unpaid carer who provides or arranges for domestic support on a regular basis