Statute Details
- Title: Advance Medical Directive Regulations 1997
- Type: Subsidiary legislation (SL)
- Authorising Act: Advance Medical Directive Act 1996 (notably, references to sections 3, 5, 7, 9 and 10)
- Act Code: AMDA1996-RG1
- Current status: Current version as at 26 Mar 2026 (per the legislative portal extract)
- Commencement: 1 July 1997 (as shown in the legislative timeline)
- Key provisions (regulations): Regulation 1 (Citation); Regulation 2 (Advance medical directive); Regulation 3 (Acknowledgment of registration); Regulation 4 (Revocation of directive); Regulation 5 (Acknowledgment of notice of revocation); Regulation 6 (Certification of terminal illness); Regulation 7 (Conscientious objector)
- Forms-based framework: The Regulations require directives, notices, acknowledgments, and medical certifications to be made in specified Forms 1–10 set out in the Schedule
What Is This Legislation About?
The Advance Medical Directive Regulations 1997 (“AMDR”) are subsidiary legislation made under the Advance Medical Directive Act 1996. In plain language, they provide the “paperwork and process rules” for how an advance medical directive is created, registered, revoked, and acted upon—particularly where the patient’s condition is said to meet the statutory threshold of a “terminal illness”.
Advance medical directives are documents in which a person (the “directing person” or “patient”) sets out their wishes regarding medical treatment in circumstances where they may later lose the capacity to make decisions. The Regulations do not themselves decide whether treatment should be withheld or provided; instead, they operationalise the Act by prescribing the exact forms and procedural steps that must be followed by patients, medical practitioners, and the Registrar who maintains the relevant register.
Practically, the AMDR matters because compliance is form-and-process driven. For practitioners, the Regulations reduce ambiguity: they specify what must be written, what must be acknowledged, who must be consulted, and how determinations about terminal illness must be recorded and communicated. This is especially important in high-stakes end-of-life contexts where disputes can arise about validity, revocation, and whether statutory safeguards were satisfied.
What Are the Key Provisions?
1. The directive must be in the prescribed Form (Regulation 2). The Regulations state that, for the purposes of section 3 of the Act, an advance medical directive must be in Form 1 set out in the Schedule. This is a core compliance point. If a directive is not in the required form, it may fail to meet the statutory requirements for registration or recognition under the Act. For lawyers advising clients, this means that drafting is not merely a matter of capturing the person’s wishes; it must be done using the mandated template and structure.
2. Registration and revocation are acknowledged using prescribed Forms (Regulations 3–5). The Regulations require formal acknowledgments. Under Regulation 3, for the purposes of section 5 of the Act, an acknowledgment of registration must be in Form 2. Under Regulation 4, a written revocation of a directive and a notice of revocation (whether the revocation was in writing or by any other way of communication) must be in Form 3. Under Regulation 5, for the purposes of section 7(5) of the Act, an acknowledgment of receipt of a notice of revocation must be in Form 4.
These provisions are significant because they address a common litigation risk: whether a revocation was properly made and received. By requiring acknowledgments in specific forms, the framework creates documentary evidence of receipt and processing. For practitioners, this supports evidential clarity when a patient’s wishes are contested after a change in circumstances or capacity.
3. Terminal illness certification is tightly procedural and multi-layered (Regulation 6). Regulation 6 is the most operationally detailed provision. It governs the certification by medical practitioners that a person is suffering from a terminal illness, and it ties that certification to the Act’s register-search and opinion-gathering mechanisms.
Key elements include:
- Regulation 6(1): A certification by a medical practitioner that a person is suffering from a terminal illness, together with a request for a search of the register under section 9(1) of the Act, must be in Form 5.
- Regulation 6(2): The Registrar must inform the medical practitioner of the result of the register search in Form 6.
- Regulation 6(3): The medical practitioner responsible for treatment must obtain the opinions of two medical practitioners required under section 9(3) of the Act, and those opinions must be in Form 7.
- Regulation 6(4)–(5): Where a committee of three specialists is appointed under section 9(5) of the Act, the Registrar must notify each specialist and obtain their opinion on whether the patient is suffering from a terminal illness in Form 8. The committee’s determination must be recorded in Form 9.
- Regulation 6(6): For the purposes of section 10(3) of the Act, the medical practitioner must certify whether the patient is pregnant—either on page 3 of Form 7 or, where the committee of three specialists is unanimously in agreement that the patient is suffering from a terminal illness, on page 2 of Form 9.
From a practitioner’s perspective, Regulation 6 is where the Act’s safeguards become concrete. It ensures that (i) the register is searched when terminal illness is certified, (ii) multiple independent medical opinions are obtained, and (iii) the outcome is recorded in a way that can be audited and relied upon. The pregnancy certification step underscores that additional clinical facts may affect the legal pathway for treatment decisions under the Act.
4. Conscientious objection must be registered and can be revoked (Regulation 7). Regulation 7 addresses the position of medical practitioners (and persons acting under their instructions) who object to acting on a directive. Under Regulation 7(1), such a person must register the objection in Part 1 of Form 10 for the purposes of section 10(1) of the Act. Under Regulation 7(2), revocation of an objection under section 10(1) must be notified to the Registrar by retrieving the form on which the objection was registered from the Registry and completing Part 2 at the Registry.
This matters because conscientious objection can affect access to directive-based care. The Regulations ensure that objections are not informal or ad hoc; they must be recorded in a prescribed manner, and any withdrawal must be processed through the Registry. For counsel, this provides a compliance checklist when advising healthcare institutions and practitioners on staffing, referral obligations, and continuity of care.
How Is This Legislation Structured?
The AMDR is structured as a short set of regulations supported by a Schedule containing the required Forms 1–10. The Regulations themselves are brief and primarily procedural. The structure is:
- Regulation 1: Citation.
- Regulation 2: Form 1 requirement for an advance medical directive.
- Regulation 3: Form 2 for acknowledgment of registration.
- Regulation 4: Form 3 for revocation and notice of revocation.
- Regulation 5: Form 4 for acknowledgment of receipt of revocation notice.
- Regulation 6: Form 5–9 framework for terminal illness certification, register search results, medical opinions, specialist committee determinations, and pregnancy certification.
- Regulation 7: Form 10 framework for registering and revoking conscientious objections.
In effect, the Schedule is the operational heart of the Regulations. While the Regulations set out “what must be done”, the Forms specify “how it must be done” in a way that supports consistency across cases.
Who Does This Legislation Apply To?
The AMDR applies to multiple participants in the advance medical directive system:
- Directing persons/patients who create an advance medical directive (Regulation 2).
- The Registrar who maintains the register and issues acknowledgments and notifications (Regulations 3, 5, and 6).
- Medical practitioners who certify terminal illness, request register searches, obtain opinions, and certify pregnancy status (Regulation 6).
- Specialists who may sit on a committee of three and provide opinions (Regulation 6).
- Medical practitioners and persons acting under their instructions who object to acting on a directive and must register that objection (Regulation 7).
Although the Regulations are subsidiary, they are legally binding in the sense that they prescribe the form and procedural steps required for the Act’s operation. In practice, healthcare institutions and practitioners should treat the forms and steps as mandatory compliance requirements rather than administrative guidance.
Why Is This Legislation Important?
The AMDR is important because it translates the Advance Medical Directive Act 1996 into a workable system. Advance directives are often invoked at moments of crisis, when time, documentation, and procedural certainty are essential. By prescribing specific forms and requiring acknowledgments and recorded determinations, the Regulations help ensure that a patient’s documented wishes are respected—while also ensuring that statutory safeguards are satisfied before those wishes are acted upon.
From an enforcement and risk-management perspective, the Regulations reduce uncertainty in three high-risk areas: validity of the directive (Form 1), revocation and receipt (Forms 3–4), and terminal illness certification (Forms 5–9). These are the points most likely to be scrutinised if there is a dispute among family members, between clinicians, or between clinicians and the patient’s recorded instructions.
For practitioners advising clients—whether patients, families, hospitals, or clinicians—the AMDR provides a practical compliance roadmap. It supports defensible documentation practices: ensuring that directives are in the correct template, that revocations are properly notified and acknowledged, and that terminal illness determinations follow the multi-practitioner and specialist committee structure contemplated by the Act.
Related Legislation
- Advance Medical Directive Act 1996 (authorising Act; referenced throughout, including sections 3, 5, 7, 9 and 10)
Source Documents
This article provides an overview of the Advance Medical Directive Regulations 1997 for legal research and educational purposes. It does not constitute legal advice. Readers should consult the official text for authoritative provisions.