Health care and special health care
- What is the health care principle?
- What medical procedures are considered "special health care"?
- Why is the Tribunal's consent needed for special health care?
- What does the Tribunal consider before giving consent to special health care matters?
- How do I apply for consent to special health care?
What is the health care principle?
The health care principle means that anyone making a decision about the adult’s health care, whether a guardian, the Adult Guardian, an attorney or the Tribunal, must exercise their authority in a way that:
- is least restrictive of the adult’s rights; and
- is necessary and appropriate to maintain the adult’s health or wellbeing; and
- is in the adult’s best interests and, to the greatest extent possible, reflects the adult’s views.
Decision-makers must also take into account information given by the adult’s health care provider.
Actions will be contrary to the health care principle if a decision does not promote the adult’s health and wellbeing. Refusing to make a decision can also be contrary to the health care principle if a decision is necessary for the adult’s continued health and well-being.
What medical procedures are considered "special health care"?
The Guardianship and Administration Act 2000 (the Act) includes the following medical procedures as special health care:
- donation of tissue from the adult to someone else for transplant (e.g., bone marrow or an organ)
- sterilisation of the adult
- termination of a pregnancy of the adult
- participation by the adult in special medical research or experimental health care
- prescribed special health care.
These procedures cannot be carried out on an adult who has impaired decision-making capacity for the particular decision without the written consent of the Tribunal.
Why is the Tribunal's consent needed for special health care?
These particular procedures go beyond the boundaries of ordinary health care because they are intended for the benefit of someone else (as in the case of tissue donation) or they have a crucial effect on the adult’s rights and freedoms (as in the case of sterilisation).
The Act protects the rights of the adult by limiting the powers of decision-makers in such sensitive matters. The Tribunal can give consent for procedures classified as ‘special health care’ to be carried out on the adult but an attorney or guardian cannot.
What does the Tribunal consider before giving consent to special health care matters?
In general, the Tribunal has to decide whether or not the procedure is necessary for the adult’s health and well-being. This means answering two crucial questions:
- Is it the option that is least restrictive of the adult’s rights?
- Is it needed to promote or maintain the adult’s health and well-being?
If the Tribunal is satisfied that the answer to both these questions is yes, it is likely to give its consent.
The Tribunal has to take several matters into account before giving consent to special health care:
- the principle of keeping treatment to the minimum necessary to preserve the adult’s health and wellbeing
- the wishes of the adult
- the views of any guardians appointed by the Tribunal
- the views of anyone appointed as attorney for personal matters for the adult
- the views of the adult’s statutory health attorney
- the adult’s situation (including their medical condition)
- any alternative procedures that may be available in either the short or long term.
How do I apply for consent to special health care?
Contact the Tribunal Registry and talk to staff about the proposed special health care. Registry staff will offer you advice and supply you with a form called Application for Consent for Special Health Care. You can also download the Application for Consent for Special Health Care form from the publications page on this website. When the form is complete, return it to the Tribunal. You will need to supply evidence, such as medical reports, to support your application.
To find out more about special health care provisions, click here to view the Guardianship and Administration Tribunal Act 2000.
Last updated 10/21/2007
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