{"id":"health-care-decision-making-act-2023","name":"Health Care Decision Making Act 2023","slug":"health-care-decision-making-act-2023","collection":"act","jurisdiction":"nt","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":30101,"registerId":"nt-health-care-decision-making-act-2023-current","compilationNumber":null,"startDate":"2026-04-01","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Health Care Decision Making Act 2023","content":"NORTHERN TERRITORY OF AUSTRALIA\nHEALTH CARE DECISION MAKING ACT 2023\nAs in force at 1 August 2025\nTable of provisions\nPart 1 Preliminary matters\n1 Short title ......................................................................................... 1\n2 Commencement .............................................................................. 1\n3 Purposes of Act ............................................................................... 1\n4 Definitions ........................................................................................ 2\n5 Presumption of capacity to make health care decisions .................. 3\n6 Meaning of health care .................................................................... 3\n7 Meaning of health care decision ...................................................... 4\n8 Meaning of impaired decision making capacity ............................... 4\n9 Meaning of willing and able ............................................................. 6\n10 Application of Criminal Code ........................................................... 6\nPart 2 Health care decision makers\n11 Authority of health care decision maker........................................... 6\n12 Scope of health care decisions ........................................................ 7\n13 Hierarchy of health care decision makers ........................................ 8\n14 Appropriate health care decision maker .......................................... 9\n15 Multiple appointees.......................................................................... 9\n16 Relinquishing authority .................................................................. 10\n17 Support to adult in making health care decision ............................ 10\n18 Decision making principles ............................................................ 10\n19 Advance consent decision ............................................................. 12\n20 Exemptions .................................................................................... 12\n21 Benefit to third party ...................................................................... 13\n22 Role of Public Guardian ................................................................. 14\nPart 3 Administering health care\n23 Initial responsibilities of health care provider ................................. 14\n24 Determination of capacity .............................................................. 15\n25 Routine health care ....................................................................... 16\n26 Palliative care ................................................................................ 16\n27 Relief from pain and distress ......................................................... 17\n28 Cosmetic surgery and other treatments ......................................... 17\n29 Role of health care decision makers regarding \"restrictive\npractices\" ....................................................................................... 17\n30 Restricted health care .................................................................... 20\n31 Reliance on health care decision makers and others .................... 21\n\nHealth Care Decision Making Act 2023 ii\n32 Reliance on consent of adult with unknown impaired decision\nmaking capacity ............................................................................. 22\n33 Other responsibilities of health care provider................................. 22\n34 Unnecessary health care ............................................................... 22\n35 Deemed unprofessional conduct ................................................... 23\n36 Other laws allowing health care without consent not affected ....... 23\n37 Other rights preserved ................................................................... 23\nPart 4 Urgent health care\n38 Application ..................................................................................... 23\n39 Urgent health care without consent ............................................... 24\nPart 5 NTCAT\n40 Application to NTCAT .................................................................... 24\n41 Orders by NTCAT .......................................................................... 25\n42 Parties ........................................................................................... 26\n43 Closed proceedings ....................................................................... 26\n44 Oral reasons and findings of fact ................................................... 27\n45 No internal review .......................................................................... 27\nPart 6 Offences\n46 Disclosure of identity information ................................................... 27\n47 False representation ...................................................................... 28\n48 Misleading information ................................................................... 29\n49 Improper exercise of authority ....................................................... 30\n50 Acting without authority ................................................................. 31\n51 Contravention of decision making principles.................................. 31\n52 Inducing contravention of decision making principles .................... 32\n53 Limitation period for prosecutions .................................................. 33\nPart 7 Administrative and other matters\n54 Senior Practitioner directives and approvals.................................. 33\n54A Delegation ..................................................................................... 34\n55 Public Guardian guidelines ............................................................ 34\n56 Report to Public Guardian ............................................................. 34\n57 Liability of health care providers .................................................... 35\n58 Regulations.................................................................................... 35\nPart 8 Repeal\n59 Act repealed .................................................................................. 35\nENDNOTES\n\nNORTHERN TERRITORY OF AUSTRALIA\n____________________\nAs in force at 1 August 2025\n____________________\nHEALTH CARE DECISION MAKING ACT 2023\nAn Act to govern the making of health care decisions for adults with\nimpaired decision making capacity, for the provision of urgent health\ncare without consent to both adults and children and for related\npurposes\nPart 1 Preliminary matters\n1 Short title\nThis Act may be cited as the Health Care Decision Making\nAct 2023.\n2 Commencement\n(1) Subject to subsection (2), this Act commences on the day fixed by\nthe Administrator by Gazette notice.\n(2) If a provision of this Act does not commence before 18 May 2025, it\ncommences on that day.\n3 Purposes of Act\nThe purposes of this Act are the following:\n(a) to provide authority to a hierarchy of persons to make\ndecisions regarding the health care of an adult with impaired\ndecision making capacity;\n(b) to include, within that hierarchy, persons with authority under\nthe Advance Personal Planning Act 2013 and the\nGuardianship of Adults Act 2016;\n(c) to establish the principles and rules for making health care\ndecisions, while protecting an adult's freedom of decision and\naction;\n\nPart 1 Preliminary matters\nHealth Care Decision Making Act 2023 2\n(d) to regulate the administration of certain types of health care\nand prohibit or restrict the making of certain health care\ndecisions, in relation to an adult with impaired decision making\ncapacity;\n(e) to provide for the administration of health care without consent\nto both adults and children in urgent circumstances.\n4 Definitions\nIn this Act:\nadvance care statement, see section 3 of the Advance Personal\nPlanning Act 2013.\nadvance consent decision means a health care decision set out\nin an advance personal plan under the Advance Personal Planning\nAct 2013.\nhealth care, see section 6.\nhealth care decision, see section 7.\nhealth care decision maker means a person determined under\nPart 2 with authority under this Act to make a health care decision.\nhealth care provider means an individual who provides health\ncare.\nimpaired decision making capacity, see section 8.\nPublic Guardian means the Public Guardian established under\nsection 60 of the Guardianship of Adults Act 2016.\nSenior Practitioner means the person appointed under section 9\nof the National Disability Insurance Scheme (Authorisations)\nAct 2019.\nwilling and able, see section 9.\nNote for section 4\nThe Interpretation Act 1978 contains definitions and other provisions that may be\nrelevant to this Act.\n\nPart 1 Preliminary matters\nHealth Care Decision Making Act 2023 3\n5 Presumption of capacity to make health care decisions\nAn adult is presumed to have capacity to make a health care\ndecision unless there is evidence to the contrary.\nNote for section 5\nIn the absence of other evidence, an adult who merely appears to have impaired\ndecision making capacity is still presumed not to have impaired decision making\ncapacity. A guardianship order could be evidence to the contrary.\n6 Meaning of health care\n(1) Health care means any kind of health care, including the following\nservices or anything provided as part of any of the following\nservices:\n(a) services provided by a health practitioner under the Health\nPractitioner Regulation National Law;\n(b) hospital services;\n(c) mental health services;\n(d) pharmaceutical services;\n(e) ambulance services;\n(f) community health services;\n(g) health education services;\n(h) welfare services necessary to implement any services referred\nto in paragraphs (a) to (g);\n(i) services provided by dietitians, massage therapists,\nnaturopaths, social workers, speech pathologists, audiologists\nor audiometrists;\n(j) pathology services;\n(k) the removal of tissue from an adult's body in accordance with\nPart 2 of the Transplantation and Anatomy Act 1979.\n(2) An assessment conducted by a health care provider for the purpose\nof assessing current or future health care requirements is taken to\nbe a form of health care.\nExample for subsection (2)\nAn aged care assessment made in relation to care under the Aged Care\nAct 1997 (Cth).\n\nPart 1 Preliminary matters\nHealth Care Decision Making Act 2023 4\n7 Meaning of health care decision\n(1) A health care decision is a decision whether to commence,\ncontinue, withdraw or withhold health care for an adult.\n(2) A health care decision to commence, continue, withdraw or\nwithhold health care made by a health care decision maker is taken\nto be consent on behalf of the adult to the commencement,\ncontinuation, withdrawal or withholding of that health care.\n(3) A health care decision to not commence, not continue, not withdraw\nor not withhold health care made by a health care decision maker is\ntaken to be refusal to consent on behalf of the adult to the\ncommencement, continuation, withdrawal or withholding of that\nhealth care.\n8 Meaning of impaired decision making capacity\n(1) An adult has impaired decision making capacity in relation to a\nhealth care decision if the adult's capacity to make the health care\ndecision is impaired.\n(2) An impairment in any of the following is relevant in determining\nwhether an adult's capacity to make the health care decision is\nimpaired:\n(a) understanding and retaining information relevant to the health\ncare decision;\n(b) weighing information relevant to the health care decision in\norder to make the health care decision;\n(c) communicating the health care decision in some way;\n(d) understanding the effect of the health care decision.\n(3) For subsection (2)(a), an adult is taken to understand information\nrelevant to a health care decision if the adult understands an\nexplanation of the information given to the adult in a way that is\nappropriate to the adult's circumstances, whether by using modified\nlanguage, visual aids or other means.\n(4) For subsection (2)(c), an adult is taken to communicate the health\ncare decision if the adult communicates the decision in a way that is\nappropriate to the adult's circumstances, whether by using modified\nlanguage, visual aids or other means.\n(5) An adult may have impaired decision making capacity in relation to\nsome matters and not others.\n\nPart 1 Preliminary matters\nHealth Care Decision Making Act 2023 5\n(6) The degree to which an adult has impaired decision making\ncapacity may vary over time.\n(7) The cause of the impairment of the decision making capacity is\nimmaterial.\n(8) An adult does not have impaired decision making capacity merely\nbecause the adult:\n(a) has a disability, illness or other medical condition, whether\nphysical or mental; or\n(b) requires the use of practicable and appropriate support,\nincluding additional time for explanation, modified language,\nvisual or technological aids or other means of communication;\nor\n(c) engages in unconventional behaviour or another form of\npersonal expression; or\n(d) chooses a living environment or lifestyle with which other\npeople do not agree; or\n(e) makes decisions with which other people do not agree; or\n(f) does not have a particular level of fluency in English; or\n(g) does not have a particular level of literacy or education; or\n(h) engages in particular cultural or religious practices; or\n(i) does or does not express a particular religious, political or\nmoral opinion; or\n(j) is of a particular sexual orientation or gender identity or\nexpresses particular sexual preferences; or\n(k) takes or took, or is or was dependent on, alcohol or drugs,\nunless the alcohol or drugs are causing actual impairment in\nrelation to the health care decision; or\n(l) engages or engaged in illegal or immoral conduct.\nExamples for subsection (8)(b)\n1 Using information or formats tailored to the particular needs of the adult.\n2 Communicating or assisting a person to communicate the adult's decision.\n3 Giving a person additional time and discussing the matter with the adult.\n4 Using technology that alleviates the effects of an adult's disability.\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 6\n9 Meaning of willing and able\nA person is willing and able to make a health care decision for an\nadult with impaired decision making capacity if the person:\n(a) has capacity to make the decision; and\n(b) is reasonably available; and\n(c) is willing to make the decision; and\n(d) understands the obligation to act in accordance with the\ndecision making principles; and\n(e) has the information reasonably needed to make a balanced\ndecision; and\n(f) has adequate time to consider that information; and\n(g) understands the effect of making the decision; and\n(h) is able to make the decision voluntarily and without undue\ninfluence from any person.\nExample for paragraph (b)\nThe person is available by telephone or video call.\n10 Application of Criminal Code\nPart IIAA of the Criminal Code applies to an offence against this\nAct.\nNote for section 10\nPart IIAA of the Criminal Code states the general principles of criminal\nresponsibility, establishes general defences, and deals with burden of proof. It\nalso defines, or elaborates on, certain concepts commonly used in the creation of\noffences.\nPart 2 Health care decision makers\n11 Authority of health care decision maker\n(1) A health care decision maker has authority to make a health care\ndecision for an adult if:\n(a) the adult has impaired decision making capacity in relation to\nthe health care decision; and\n(b) the adult has not made an advance consent decision in an\nadvance personal plan in relation to the health care decision.\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 7\n(2) A health care decision maker has no authority under this Act\nregarding the following:\n(a) any treatment or care ordered by the Local Court under the\nDisability Services Act 1993;\n(b) any treatment under the Mental Health and Related Services\nAct 1998:\n(i) for complex cognitive impairment or mental illness; or\n(ii) of a mentally disturbed person;\n(c) any neurosurgery for mental illness.\n(3) In this section:\ncomplex cognitive impairment, see section 6A of the Mental\nHealth and Related Services Act 1998.\nmental illness, see section 6 of the Mental Health and Related\nServices Act 1998.\nmentally disturbed, see section 4 of the Mental Health and\nRelated Services Act 1998.\n12 Scope of health care decisions\n(1) A health care decision may be made in relation to health care to be\nprovided:\n(a) in specified circumstances; or\n(b) as a course of health care to be provided over a period of\ntime.\n(2) Subsection (1) does not authorise a health care decision maker to\navoid responsibility by delegating a health care decision to\nsomeone else.\nExample for subsection (2)\nA health care decision maker cannot decide to have someone else make the\nhealth care decision in the future, but would allow consent to be given to a\nsurgeon to make immediately required decisions during surgery.\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 8\n13 Hierarchy of health care decision makers\nThe following persons, listed in descending order of priority, are the\npotential health care decision makers for an adult with impaired\ndecision making capacity:\n(a) a person with health care authority appointed by the adult in\nan advance personal plan under the Advance Personal\nPlanning Act 2013 or an equivalent document under a law of a\nState or another Territory;\n(b) a guardian of the adult with health care authority appointed\nunder the Guardianship of Adults Act 2016;\n(c) a relative of the adult who is considered by Aboriginal or other\ncustomary law or tradition to be the appropriate person to be a\nhealth care decision maker;\n(d) a spouse or de facto partner of the adult who has a close and\ncontinuing relationship with the adult;\n(e) a person who is the carer of the adult and not providing that\ncare as a service on a commercial basis;\n(f) a child of the adult who has a close and continuing\nrelationship with the adult;\n(g) a parent of the adult who has a close and continuing\nrelationship with the adult;\n(h) a sibling of the adult who has a close and continuing\nrelationship with the adult;\n(i) a friend of the adult who has a close and continuing\nrelationship with the adult.\nNotes for section 13\n1 The persons specified in paragraphs (a) and (b) are appointed under other\nlegislation and accordingly have statutory functions. The other persons in the\nsection are persons with familial or other connections to the adult.\n2 A friend or relative is not precluded from being a health care decision maker\nbecause they are receiving a carer payment from the Commonwealth to be a\ncarer of the adult.\n3 The Public Guardian may make guidelines on applying and interpreting this\nsection. See section 55(a).\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 9\n14 Appropriate health care decision maker\n(1) If needed to make a health care decision for an adult with impaired\ndecision making capacity, the appropriate health care decision\nmaker is the person specified in section 13 who meets the following\ncriteria:\n(a) the person has the highest priority under that section;\n(b) the person is an adult;\n(c) the person is willing and able to make the decision.\n(2) If a guardian with health care authority is appointed for the adult\nunder the Guardianship of Adults Act 2016 after another person\nhad authority as the adult's health care decision maker, the\nguardian becomes the health care decision maker instead of the\nother person.\n(3) If a person specified in section 13(a) or (b) exists but is not willing\nand able to make a health care decision, that person must apply to\nNTCAT for an order under section 41(1)(c), unless it is not\nreasonably practicable to do so.\n(4) The application under subsection (3) must be made as soon as\npracticable.\n(5) The Public Guardian is taken to be the health care decision maker\nfor an adult if an application is required but not made in accordance\nwith subsections (3) and (4).\n15 Multiple appointees\n(1) This section applies if 2 or more persons referred to in section 13(a)\nor (b) are appointed.\n(2) All of the persons appointed are considered to be the health care\ndecision maker and must exercise their authority in accordance with\ntheir appointment.\nNote for subsection (2)\nThey may be appointed to act jointly, severally or jointly and severally.\n(3) If a person appointed is not willing and able to make the decision,\nthe remaining person or persons have authority to make the health\ncare decision, unless the persons are jointly appointed.\n(4) If 2 or more persons who are severally appointed agree on the\nhealth care decision, any one of them may make the decision.\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 10\n(5) If 2 or more persons who are jointly appointed do not agree on the\nhealth care decision, none of them may make the decision.\n16 Relinquishing authority\n(1) A health care decision maker, other than one specified in\nsection 13(a) or (b), may relinquish authority under this Act at any\ntime for any reason.\n(2) If a health care decision maker relinquishes authority, the next\nperson who meets the criteria of section 14(1) is the appropriate\nhealth care decision maker.\n17 Support to adult in making health care decision\n(1) Before exercising authority under this Act, a health care decision\nmaker must make a reasonable effort to use any practicable\nsupport appropriate to the circumstances to assist the adult in\nmaking the health care decision.\n(2) A health care decision maker may also consult other persons who\nmay have relevant information before exercising authority under\nthis Act.\n18 Decision making principles\n(1) This section governs the exercise of authority of a health care\ndecision maker to make a health care decision in relation to an\nadult with impaired decision making authority.\n(2) Subject to sections 20(1) and 41(1)(e), the health care decision\nmaker must give effect to any advance care statement, about the\nhealth care decision, made by the adult.\n(3) If no advance care statement was made about the health care\ndecision, the health care decision maker must exercise authority\nunder this Act in the way the health care decision maker believes\non reasonable grounds the adult would in the circumstances.\n(4) In determining what the adult would do in the circumstances, the\nhealth care decision maker must take into account:\n(a) the adult's current and previously stated decisions, views,\nwishes and objections about the matter; and\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 11\n(b) the health care decision maker's personal knowledge of the\nadult.\nNote for subsection (4)(a)\nThis would include the advance personal plan for a person with health care\nauthority appointed under the Advance Personal Planning Act 2013.\n(5) If a health care decision maker forms a belief on reasonable\ngrounds regarding what the adult would do in the circumstances,\nthe health care decision maker must exercise authority in that way,\neven if doing so may not be in the adult's best interests.\nNote for subsection (5)\nCertain decisions, practices and health care are restricted or limited under\nsections 29 and 30.\n(6) Subsection (5) does not require giving the adult addictive\nsubstances, without therapeutic benefit, that the adult would use if\nthe adult had legal capacity.\n(7) If a health care decision maker is unable to form a belief on\nreasonable grounds regarding what the adult would do in the\ncircumstances, the health care decision maker must exercise\nauthority in the way that the decision maker believes on reasonable\ngrounds is in the best interests of the adult.\n(8) For subsection (7), in determining what is in the best interests of the\nadult, the health care decision maker must:\n(a) take into account all relevant considerations; and\n(b) assess those considerations by giving each of them the weight\nthe health care decision maker believes on reasonable\ngrounds is appropriate in the circumstances.\n(9) Without limiting subsection (8)(a), relevant considerations regarding\nthe adult include the following:\n(a) protecting the adult from harm, neglect, abuse and\nexploitation;\n(b) providing the adult with appropriate care;\n(c) promoting the adult's happiness, enjoyment of life and\nwellbeing;\n(d) protecting the adult's freedom of decision and action;\n(e) enabling the adult to be as independent as practicable;\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 12\n(f) enabling the adult to achieve the adult's maximum physical,\nsocial, emotional and intellectual potential;\n(g) enabling the adult to live in the general community and take\npart in community activities;\n(h) maintaining the adult's right to be treated with dignity and\nrespect;\n(i) enabling the adult to maintain the adult's preferred living\nenvironment and lifestyle;\n(j) maintaining or creating a positive support network for the\nadult;\n(k) protecting the adult's property and financial resources from\nloss, damage and misuse;\n(l) protecting the adult's right to keep the adult's information\nconfidential.\n(10) In determining what is appropriate in the circumstances under\nsubsection (8)(b), the health care decision maker must exercise\nauthority in a way that:\n(a) is the least restrictive of the adult's freedom of decision and\naction as is practicable; and\n(b) provides the adult with as much support as is practicable to\nmake the adult's own health care decisions.\n19 Advance consent decision\nSubject to section 41, an advance consent decision made by an\nadult has effect for all purposes as if it is a health care decision\nmade by a fully informed adult with capacity to make the health\ncare decision.\n20 Exemptions\n(1) A health care decision maker is not required to comply with\nsection 18(2) if:\n(a) the adult made a subsequent written declaration stating that\nthe adult does not want to give effect to the advance care\nstatement, at a time when the adult did not have impaired\ndecision making capacity to make a health care decision; or\n(b) there is no reasonable possibility the adult would have\nintended the statement to apply in the circumstances.\n\nPart 2 Health care decision makers\nHealth Care Decision Making Act 2023 13\n(2) A health care decision maker is not required to comply with\nsection 18(2) or (3) if compliance would:\n(a) be impracticable; or\n(b) be unlawful; or\n(c) impose a burden on another person that is so unreasonably\nonerous that it is justifiable to override the adult's wishes; or\n(d) be so unreasonable that it is justifiable to override the adult's\nwishes.\n(3) If a health care decision maker relies on subsection (1) or (2), the\nhealth care decision maker must keep a written record of the\nreasons for not complying with section 18(2) or (3), as the case\nmay be.\n21 Benefit to third party\nA health care decision maker may exercise authority under this Act\nin a way that benefits a person other than the adult with impaired\ndecision making capacity if:\n(a) the benefit to the other person is of a kind that the adult with\nimpaired decision making capacity:\n(i) provided to the other person before their decision\nmaking capacity became impaired; or\n(ii) might reasonably be expected to provide to the other\nperson but for the impaired decision making capacity;\nand\n(b) providing the benefit to the other person:\n(i) would be reasonable in the circumstances; and\n(ii) would not have a significantly adverse effect on the best\ninterests of the adult with impaired decision making\ncapacity.\nExample for section 21\nA health care decision maker might consent to the adult with impaired decision\nmaking capacity donating bone marrow to treat a child of the adult with\nleukaemia, even though doing so may involve some risk to the adult.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 14\n22 Role of Public Guardian\n(1) The Public Guardian has authority to make a health care decision\nfor an adult if:\n(a) the adult has impaired decision making capacity in relation to\nthe health care decision; and\n(b) the adult has not made an advance consent decision in an\nadvance personal plan in relation to the health care decision;\nand\n(c) no health care decision maker meets the criteria of\nsection 14(1); and\n(d) no application is made to NTCAT for an order under\nsection 41(1)(c).\n(2) In addition to subsection (1), the Public Guardian has authority to\nmake a health care decision for an adult if:\n(a) appointed as the adult's guardian with health care authority\nunder the Guardianship of Adults Act 2016; or\n(b) appointed as a person with health care authority for the adult\nunder the Advance Personal Planning Act 2013; or\n(c) ordered to be the health care decision maker by NTCAT under\nsection 41(1)(c)(i).\n(3) The following provisions of this Act apply to the making of a health\ncare decision by the Public Guardian under subsections (1) and (2):\n(a) section 15;\n(b) sections 17 to 21;\n(c) sections 27 to 30.\nPart 3 Administering health care\n23 Initial responsibilities of health care provider\n(1) Before administering health care to an adult with impaired decision\nmaking capacity, a health care provider must make reasonable\nefforts in the circumstances to ascertain if the adult made an\nadvance consent decision in relation to the health care.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 15\n(2) Subject to sections 33(2) and 41(2), a health care provider has\nauthority to administer health care to an adult with impaired\ndecision making capacity in accordance with the adult's advance\nconsent decision in relation to the health care, without the consent\nof a health care decision maker.\nNote for subsection (2)\nSection 19 provides for the effect of an advance care consent decision.\n(3) If after reasonable efforts the health care provider is not aware of\nan advance consent decision, the health care provider must make\nreasonable efforts in the circumstances to contact the appropriate\nhealth care decision maker for the adult with impaired decision\nmaking capacity.\n(4) A health care provider must keep a written record of the provider's\nefforts to comply with subsections (1) and (3).\n(5) For this section, a health care provider must make reasonable\nefforts to follow any guidelines issued by the Public Guardian under\nsection 55(b).\nNote for section 23\nThese responsibilities are subject to Part 4 regarding administration of health\ncare in urgent circumstances.\n24 Determination of capacity\n(1) Before a health care decision maker makes a health care decision\nfor an adult with impaired decision making capacity, the health care\nprovider who would administer the health care must first determine:\n(a) the extent of the adult's impairment in relation to the decision;\nand\n(b) whether the impairment is likely to be temporary or\npermanent; and\n(c) whether the health care decision maker needs to exercise\nauthority to make the decision in the circumstances.\n(2) The determination under subsection (1) must be done in\ncollaboration with the health care decision maker if reasonably\npracticable.\n(3) If the health care provider determines the adult's impairment to be\ntemporary, any health care provided to the adult must be limited to\nwhat is necessary during the expected period of impairment.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 16\n(4) For this section, a health care provider must make reasonable\nefforts to follow any guidelines issued by the Public Guardian under\nsection 55(c).\n25 Routine health care\n(1) A health care provider may administer routine health care to an\nadult with impaired decision making capacity without the consent of\na health care decision maker.\n(2) Subsection (1) authorises administering routine personal hygiene\nand grooming.\n(3) Subsections (1) and (2) do not authorise a health care provider to\nadminister any health care that:\n(a) is objected to by the adult; or\n(b) consists of an ongoing course of treatment; or\n(c) causes a significant degree of intrusion into the body of the\nadult; or\n(d) creates a significant risk of harm to the adult; or\n(e) causes significant side-effects to the adult; or\n(f) causes significant pain or distress to the adult.\n(4) For this section, a health care provider must make reasonable\nefforts to follow any guidelines issued by the Public Guardian under\nsection 55(d).\n26 Palliative care\n(1) A health care provider may administer palliative care to an adult\nwith impaired decision making capacity without the consent of, and\ndespite an objection from, a health care decision maker, if the adult:\n(a) has an active, progressive and advanced disease; and\n(b) has little or no prospect of cure and is expected to die.\n(2) The health care provider must consult with the health care decision\nmaker before administering palliative care to an adult with impaired\ndecision making capacity.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 17\n(3) In addition to the duty in section 23, a health care provider must\nhave regard to any preferences and values of the adult with\nimpaired decision making capacity known to the health care\nprovider when making a decision to administer palliative care under\nsubsection (1).\n(4) In this section:\npalliative care means reasonable treatment for the relief of pain,\nsuffering and distress provided to an adult:\n(a) with an active, progressive and advanced disease; and\n(b) who has little or no prospect of cure; and\n(c) who is expected to die; and\n(d) for whom the primary goal is to optimise the quality of life.\n27 Relief from pain and distress\n(1) A health care decision maker must exercise their authority to\nensure that an adult with impaired decision making capacity does\nnot needlessly suffer significant pain or distress.\n(2) A health care provider may administer health care that provides\nrelief to an adult with impaired decision making capacity from\nsignificant pain or distress without the consent of, and despite an\nobjection from, a health care decision maker.\n28 Cosmetic surgery and other treatments\nA health care decision maker has authority to consent to the\nadministration of cosmetic surgery, botulinum toxin injections or\nbody piercing to an adult with impaired decision making capacity if:\n(a) the procedure is justified as health care; or\n(b) both of the following apply:\n(i) the adult gave explicit directions to have the procedure\nbefore their decision making capacity became impaired;\n(ii) the procedure carries a low risk of harm to the adult.\n29 Role of health care decision makers regarding \"restrictive\npractices\"\n(1) A health care decision maker has no authority to consent to any\npractice or health care that has the effect of restricting the rights or\nfreedom of movement of an adult with impaired decision making\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 18\ncapacity in relation to that practice or health care, including, but not\nlimited to, the following:\n(a) seclusion of an adult in a room or place where voluntary exit is\nprevented or where it is implied that voluntary exit is not\npermitted;\n(b) chemical restraint of an adult for the primary purpose of\ninfluencing the adult's behaviour;\n(c) mechanical restraint of an adult to prevent, restrict or subdue\nthe adult's movement for the primary purpose of influencing\nthe adult's behaviour;\n(d) physical restraint of an adult by physical force to prevent,\nrestrict or subdue movement of the adult's body, or part of\ntheir body, for the primary purpose of influencing their\nbehaviour;\n(e) environmental restraint of an adult preventing free access to\ntheir preferred activities or to all parts of their environment,\nincluding their personal belongings or other items.\n(2) Despite subsection (1), a health care decision maker has authority\nto consent to the following practices or health care being\nadministered by a health care provider:\n(a) the use of drugs or chemicals if:\n(i) they are used for the treatment of, or to enable the\ntreatment of, a diagnosed illness, injury or other organic\nmalfunction; and\n(ii) they are the least restrictive method of treatment in the\ncircumstances;\n(b) the use of a hands-on technique to restrain an adult if:\n(i) used to prevent potential injury or harm to the adult or\nothers; and\n(ii) used in a manner consistent with reasonable care of the\nadult; and\n(iii) it is the least restrictive method of prevention in the\ncircumstances;\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 19\n(c) seclusion as mentioned in subsection (1)(a) if:\n(i) it is reasonably required to assist in the management of\nthe adult; and\n(ii) used in a manner consistent with reasonable care of the\nadult; and\n(iii) it is the least restrictive method of prevention in the\ncircumstances;\n(d) a practice expressly approved by, or allowed by a directive\nissued by, the Senior Practitioner under section 54;\n(e) a practice or health care expressly approved in relation to a\nparticular adult by:\n(i) if the adult is receiving health care at a public hospital –\nthe medical practitioner who is director of medical\nservices for the hospital; or\n(ii) if the adult is receiving health care at a private hospital –\nthe medical practitioner who is the manager of the\nhospital under the Private Hospitals Act 1981;\n(f) a practice or health care:\n(i) otherwise permitted by section 25; or\n(ii) authorised or required under another law of the Territory;\nor\n(iii) prescribed by regulation.\n(3) An approval of a particular practice or health care in relation to a\nparticular adult under subsection (2)(e):\n(a) has effect for a period of no longer than 72 hours, as specified\nin the approval; and\n(b) cannot be reapproved.\n(4) In administering any practice or health care mentioned in this\nsection, a health care provider must make reasonable efforts to\nfollow any directives issued by the Senior Practitioner under\nsection 54.\nNote for section 29\nAn advance consent decision may be made about a matter to which this section\napplies.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 20\n30 Restricted health care\n(1) Subject to subsections (2) and (3), a health care decision maker\nhas no authority in relation to the following:\n(a) sterilisation;\n(b) termination of a pregnancy;\n(c) removal of non-regenerative tissue, as defined in section 4 of\nthe Transplantation and Anatomy Act 1979, for transplantation\ninto another person;\n(d) special medical research or experimental health care that:\n(i) relates to a condition the adult has or to which the adult\nhas a significant risk of being exposed; or\n(ii) is intended to gain knowledge for use in the diagnosis,\nmaintenance or treatment of a condition the adult has or\nhad;\n(e) health care that is not yet accepted as evidence-based or best\npractice by a substantial number of health care providers\nspecialising in the relevant area of health care;\n(f) electroconvulsive therapy;\n(g) any treatment that involves the use of an aversive stimulus,\nwhether mechanical, chemical, physical or otherwise;\n(h) any procedure prescribed by regulation.\n(2) A health care decision maker has authority to consent to the\nadministration of a procedure referred to in subsection (1)(a) or (b)\nto an adult if:\n(a) the primary reason for the procedure is to treat an illness,\ninjury or other organic malfunction; and\n(b) serious or irreversible damage to the adult's health is likely\nunless the procedure is performed.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 21\n(3) Subsection (1)(d) does not prohibit research (including\npsychological research), a clinical trial or the collection of\ninformation:\n(a) that is:\n(i) approved by a Human Research Ethics Committee\nregistered with the National Health and Medical\nResearch Council; and\n(ii) conducted in accordance with any human research\nguidelines made under section 10 of the National Health\nand Medical Research Council Act 1992 (Cth); or\n(b) that is prescribed by regulation.\nNote for section 30\nAn advance consent decision may be made about a matter to which this section\napplies.\n31 Reliance on health care decision makers and others\n(1) A health care provider who administers health care to an adult is\ntaken, for all purposes, to have the consent of the adult in relation\nto that health care, if the health care provider:\n(a) believes on reasonable grounds the adult has impaired\ndecision making capacity in relation to making a health care\ndecision; and\n(b) relies on the consent to the health care or a health care\ndecision given by:\n(i) the adult in an advance consent decision; or\n(ii) another person whom the health care provider believes\non reasonable grounds to be the appropriate health care\ndecision maker for the adult; or\n(iii) the Public Guardian under section 22; or\n(iv) NTCAT under section 41(1)(c) or (d).\n(2) For subsection (1)(b)(i), the health care provider may rely on an\nadvance consent decision that NTCAT previously ordered to be\ndisregarded if the health care provider does not know, and could\nnot reasonably be expected to know, about the order.\n(3) Subsection (1) has effect even if administering the health care will\nhasten the death of the adult.\n\nPart 3 Administering health care\nHealth Care Decision Making Act 2023 22\n32 Reliance on consent of adult with unknown impaired decision\nmaking capacity\n(1) A health care provider who administers health care to an adult is\ntaken, for all purposes, to have the consent of the adult in relation\nto that health care if:\n(a) the health care provider relies in good faith on consent\npurportedly given by the adult; and\n(b) the adult has impaired decision making capacity in relation to\nmaking a decision about the health care; and\n(c) the health care provider does not know, and could not\nreasonably be expected to know, that the adult has impaired\ndecision making capacity in relation to a decision about the\nhealth care.\n(2) Subsection (1) has effect even if administering the health care will\nhasten the death of the adult.\n33 Other responsibilities of health care provider\n(1) Nothing in this Act affects any other duty of care owed by a health\ncare provider to a person.\n(2) Nothing in this Act relieves a health care provider from the\nrequirement to comply with any of the following in administering\nhealth care under this Act:\n(a) another law of the Territory;\n(b) any requirements applicable to the health care provider by any\nrelevant professional organisation;\n(c) any operational requirements for the administration of the\nhealth care.\n34 Unnecessary health care\nNothing in this Act requires a health care provider to administer\nhealth care that is extraordinary, excessively burdensome, intrusive\nor futile.\n\nPart 4 Urgent health care\nHealth Care Decision Making Act 2023 23\n35 Deemed unprofessional conduct\nA health care provider's conduct constitutes unprofessional conduct\nfor the Health Practitioner Regulation National Law and any other\nlaw prescribed by regulation if:\n(a) the health care provider believes on reasonable grounds that\nan adult has impaired decision making capacity to make a\nhealth care decision; and\n(b) administering the health care requires a health care decision\nmade in accordance with this Act; and\n(c) the health care provider administers the health care to the\nadult without that health care decision.\n36 Other laws allowing health care without consent not affected\nThis Act does not affect the operation of any other law of the\nTerritory that allows a person to administer health care to another\nperson without that other person's consent.\nExample for section 36\nPart 3 of the Mental Health and Related Services Act 1998.\n37 Other rights preserved\n(1) This Act does not affect any right of an adult with capacity to make\na health care decision.\n(2) This Act does not affect the common law relating to the recognition\nof an adult's instructions about their health care that are given other\nthan in an advance personal plan.\nPart 4 Urgent health care\n38 Application\n(1) This Part applies in relation to the administration of health care to\nboth adults and children.\n(2) Parts 2 and 3 are subject to this Part and if a provision of those\nParts is inconsistent with this Part, this Part prevails to the extent of\nthe inconsistency.\n\nPart 5 NTCAT\nHealth Care Decision Making Act 2023 24\n39 Urgent health care without consent\n(1) A health care provider may administer health care to an individual\nwithout the consent of the individual or any other person if the\nhealth care provider believes on reasonable grounds that:\n(a) the health care is necessary, as a matter of urgency to:\n(i) save the individual's life; or\n(ii) prevent serious damage to the individual's health; or\n(iii) prevent the individual suffering, or continuing to suffer,\nfrom significant pain or distress; and\n(b) the individual has impaired decision making capacity in\nrelation to the health care; and\n(c) it is not practicable to delay the health care to obtain or\nattempt to obtain consent from:\n(i) if the impaired decision making capacity is temporary –\nthe individual; or\n(ii) a health care decision maker; and\n(d) the health care is limited to what is necessary, as a matter of\nurgency.\n(2) Subsection (1) does not authorise a health care provider to\nadminister health care to an individual if the health care provider is\naware the individual has refused that health care by way of:\n(a) an advance consent decision; or\n(b) a previously informed refusal when the individual did not have\nimpaired decision making capacity.\nPart 5 NTCAT\n40 Application to NTCAT\n(1) An application may be made to NTCAT for an order under\nsection 41 by the following persons:\n(a) a health care provider who has the care of, or is administering\nhealth care to, an adult;\n(b) the health care decision maker for an adult;\n\nPart 5 NTCAT\nHealth Care Decision Making Act 2023 25\n(c) the Public Guardian;\n(d) any other person who NTCAT is satisfied has a special\ninterest in the affairs of the adult.\n(2) Subject to subsection (3), an application must be commenced as\nsoon as practicable.\n(3) An application on the grounds that a health care decision maker\nmade or is making a health care decision contrary to the wishes of\nan adult must be filed without delay after the applicant forms a\nreasonable belief of those grounds.\nNote for subsection (3)\nThe application should be filed within a day of forming the belief if possible.\n41 Orders by NTCAT\n(1) NTCAT may, by order, do one or more of the following:\n(a) limit or vary a health care decision or the authority of a health\ncare decision maker to make a health care decision under this\nAct;\n(b) decide who is the appropriate health care decision maker for\nan adult with impaired decision making capacity;\n(c) if a person specified in section 13(a) or (b) is not willing or able\nto make a health care decision:\n(i) determine who should be the health care decision\nmaker; or\n(ii) make the health care decision itself;\n(d) approve or allow any practice or health care for which a health\ncare decision maker has no authority under section 29 or 30;\n(e) subject to subsection (2), disregard an advance consent\ndecision;\n(f) provide for any related matter it considers necessary.\n(2) NTCAT may order that an advance consent decision be\ndisregarded only if satisfied that:\n(a) there is no reasonable possibility that the adult would have\nintended the advance consent decision to apply in the\ncircumstances; or\n\nPart 5 NTCAT\nHealth Care Decision Making Act 2023 26\n(b) the advance consent decision was not an informed decision;\nor\n(c) giving effect to the advance consent decision:\n(i) would cause the adult unacceptable pain and suffering;\nor\n(ii) would otherwise be so wholly unreasonable that it is\njustifiable to override the adult's wishes.\n(3) NTCAT may make an order under subsection (1) on application or\non its own initiative.\n(4) The authority to make orders under this section comes within\nNTCAT's original jurisdiction.\n(5) NTCAT must act in accordance with the decision making principles\nin section 18 when making a health care decision.\n42 Parties\n(1) The following persons are parties to any proceeding before NTCAT\nunder this Act:\n(a) the adult to whom the health care is to be administered or for\nwhom the health care decision is to be made;\n(b) any person who commenced the proceeding;\n(c) any health care decision maker who is the subject of the\nproceeding;\n(d) any person whose selection as a health care decision maker\nis the subject of the proceeding.\n(2) The Public Guardian may intervene in any proceeding before\nNTCAT under this Act in which it is not a party.\n43 Closed proceedings\n(1) Despite section 60 of the Northern Territory Civil and Administrative\nTribunal Act 2014 but subject to subsection (2):\n(a) a proceeding under this Part is not open to the public and\nmust be heard in private; and\n(b) information that identifies, or is likely to lead to the\nidentification of, an adult who is the subject of the proceeding\nmust not be published.\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 27\n(2) If satisfied that it is in the public interest, NTCAT may, by order:\n(a) open to the public a proceeding under this Part; and\n(b) authorise publication of information prohibited under\nsubsection (1)(b).\n44 Oral reasons and findings of fact\n(1) Despite section 105(2) of the Northern Territory Civil and\nAdministrative Tribunal Act 2014, NTCAT may give the reasons for\na decision and any relevant findings of fact in any proceeding orally\nto the parties to the proceeding.\n(2) If requested by a party, NTCAT must give the reasons in writing to\nthe parties within 28 days after the day the request is made.\n(3) A request referred to in subsection (2) must be made within 28 days\nafter the day the reasons are given orally.\n(4) The President of NTCAT may extend the time limits in\nsubsections (2) and (3).\n45 No internal review\nSection 140(1) of the Northern Territory Civil and Administrative\nTribunal Act 2014 does not apply in relation to a decision of NTCAT\nunder this Act.\nPart 6 Offences\n46 Disclosure of identity information\nA person commits an offence if:\n(a) the person intentionally engages in conduct; and\n(b) the conduct results in the disclosure of information that\nidentifies, or is likely to lead to the identification of, an adult\nwho is the subject of a proceeding under Part 5; and\n(c) the disclosure is not:\n(i) authorised by an order of NTCAT; or\n(ii) for a purpose connected with the administration of this\nAct, including a legal proceeding arising out of the\noperation of this Act; or\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 28\n(iii) to a person who is otherwise entitled to the information;\nand\n(d) the person is reckless in relation to the result and\ncircumstances referred to in paragraph (b) and (c).\nMaximum penalty: 200 penalty units or imprisonment for\n2 years.\nNote for section 46\nIn addition to the circumstances specified in this section, a person who discloses\ninformation specified in this section will not be criminally responsible for an\noffence if the disclosure is justified or excused by or under a law (see\nsection 43BE of the Criminal Code).\n47 False representation\n(1) A person commits an offence if:\n(a) the person intentionally represents, by words or conduct, that\nthe person or another person:\n(i) is a health care decision maker; or\n(ii) is a health care decision maker with authority for a\nparticular matter; and\n(b) the representation is false and the person has knowledge of\nthat circumstance.\nMaximum penalty: 200 penalty units or imprisonment for\n2 years.\n(2) A person commits an offence if:\n(a) the person represents, by words or conduct, that the person or\nanother person:\n(i) is a health care decision maker; or\n(ii) is a health care decision maker with authority for a\nparticular matter; and\n(b) the representation is false and the person has knowledge of\nthat circumstance; and\n(c) the person engages in the conduct mentioned in paragraph (a)\nwith the intention of obtaining a benefit for the person or\nanother person.\nMaximum penalty: Imprisonment for 7 years.\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 29\n(3) Subsection (2)(c) is the fault element for the conduct in\nsubsection (2)(a).\n48 Misleading information\n(1) A person commits an offence if:\n(a) the person intentionally gives information to another person;\nand\n(b) the other person is:\n(i) the Public Guardian; or\n(ii) the Senior Practitioner; or\n(iii) a member of NTCAT; or\n(iv) a health care provider; or\n(v) a health care decision maker; or\n(vi) a person acting under the authority of a person specified\nin subparagraph (i), (ii), (iii), (iv) or (v); and\n(c) the information is misleading and the person has knowledge of\nthat circumstance; and\n(d) the other person is acting in an official capacity and the person\nhas knowledge of that circumstance.\nMaximum penalty: 400 penalty units or imprisonment for\n2 years.\n(2) A person commits an offence if:\n(a) the person intentionally gives a document to another person;\nand\n(b) the other person is:\n(i) the Public Guardian; or\n(ii) the Senior Practitioner; or\n(iii) a member of NTCAT; or\n(iv) a health care provider; or\n(v) a health care decision maker; or\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 30\n(vi) a person acting under the authority of a person specified\nin subparagraph (i), (ii), (iii), (iv) or (v); and\n(c) the document contains misleading information and the person\nhas knowledge of that circumstance; and\n(d) the other person is acting in an official capacity and the person\nhas knowledge of that circumstance.\nMaximum penalty: 400 penalty units or imprisonment for\n2 years.\n(3) Strict liability applies to subsections (1)(b) and (2)(b).\n(4) It is a defence to a prosecution for an offence against\nsubsection (1) or (2) if the defendant, when giving the information or\ndocument:\n(a) draws the misleading aspect of the information or document to\nthe other person's attention; and\n(b) to the extent to which the defendant can reasonably do so –\ngives the other person the information necessary to remedy\nthe misleading aspect of the information or document.\nNote for subsection (4)\nThe defendant has an evidential burden in relation to the matters mentioned (see\nsection 43BU of the Criminal Code).\n(5) In this section:\nacting in an official capacity means exercising powers or\nperforming functions under, or otherwise related to the\nadministration of, this Act.\n49 Improper exercise of authority\n(1) A person commits an offence if:\n(a) the person intentionally engages in conduct; and\n(b) the conducts purports to be the exercise of authority as a\nhealth care decision maker for an adult; and\n(c) the adult does not have impaired decision making capacity for\nthat health care decision and the person is reckless in relation\nto that circumstance.\nMaximum penalty: 400 penalty units or imprisonment for\n5 years.\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 31\n(2) A person commits an offence if:\n(a) the person engages in conduct; and\n(b) the conducts purports to be the exercise of authority as a\nhealth care decision maker for an adult; and\n(c) the adult does not have impaired decision making capacity for\nthat health care decision and the person is reckless in relation\nto that circumstance; and\n(d) the person engages in the conduct mentioned in paragraph (a)\nwith the intention obtaining a benefit for the person or another\nperson.\nMaximum penalty: 400 penalty units or imprisonment for\n7 years.\n(3) Subsection (2)(d) is the fault element for the conduct in\nsubsection (2)(a).\n(4) Strict liability applies to subsections (1)(b) and (2)(b).\n50 Acting without authority\n(1) A person commits an offence if:\n(a) the person intentionally makes a health care decision; and\n(b) the health care decision is in relation to an adult with impaired\ndecision making capacity; and\n(c) the person is not a health care decision maker and the person\nis reckless in relation to that circumstance.\nMaximum penalty: 400 penalty units or imprisonment for\n5 years.\n(2) Strict liability applies to subsection (1)(b).\n51 Contravention of decision making principles\n(1) A person commits an offence if:\n(a) the person is a health care decision maker; and\n(b) the person intentionally engages in conduct in the exercise of\nthe decision maker's authority as a health care decision\nmaker; and\n\nPart 6 Offences\nHealth Care Decision Making Act 2023 32\n(c) the conduct results in a contravention of section 18 and the\ndecision maker is reckless in relation to that result; and\n(d) the conduct is not exempted by section 20.\nMaximum penalty: 400 penalty units or imprisonment for\n5 years.\n(2) A person commits an offence if:\n(a) the person is a health care decision maker; and\n(b) the person engages in conduct in the exercise of the decision\nmaker's authority as a decision maker; and\n(c) the conduct results in a contravention of section 18 and the\ndecision maker is reckless in relation to that result; and\n(d) the person engages in the conduct mentioned in paragraph (a)\nwith the intention obtaining a benefit for the person or another\nperson; and\n(e) the conduct is not exempted by section 20.\nMaximum penalty: 400 penalty units or imprisonment for\n7 years.\n(3) Subsection (2)(d) is the fault element for the conduct in\nsubsection (2)(b).\n(4) Strict liability applies to subsections (1)(d) and (2)(e).\n52 Inducing contravention of decision making principles\n(1) A person commits an offence if:\n(a) the person intentionally engages in conduct; and\n(b) the conduct induces a health care decision maker to\ncontravene section 18 and the person has intention in relation\nto that result; and\n(c) the result is not exempted by section 20.\nMaximum penalty: 400 penalty units or imprisonment for\n5 years.\n(2) A person commits an offence if:\n(a) the person engages in conduct; and\n\nPart 7 Administrative and other matters\nHealth Care Decision Making Act 2023 33\n(b) the conduct induces a health care decision maker to\ncontravene section 18 and the person has intention in relation\nto that result; and\n(c) the person engages in the conduct mentioned in paragraph (a)\nwith the intention of obtaining a benefit for the person or\nanother person; and\n(d) the result is not exempted by section 20.\nMaximum penalty: 400 penalty units or imprisonment for\n7 years.\n(3) Subsection (2)(c) is the fault element for the conduct in\nsubsection (2)(a).\n(4) Strict liability applies to subsections (1)(c) and (2)(d).\n53 Limitation period for prosecutions\n(1) Proceedings for an offence against this Act may not be brought\nlater than 2 years after the day on which the offence was\ncommitted.\n(2) A proceeding for an offence may be brought after the end of the\nlimitation period in subsection (1) if:\n(a) fresh evidence relevant to the offence is discovered; and\n(b) the court of competent jurisdiction is satisfied that the\nevidence could not reasonably have been discovered within\nthe limitation period.\n(3) For subsection (1), if an offence is committed on more than 1 day,\nthe period of time is to be counted from the last day.\nPart 7 Administrative and other matters\n54 Senior Practitioner directives and approvals\n(1) The Senior Practitioner may, in consultation with the Public\nGuardian, issue the following:\n(a) general directives regarding the use of a practice referred to in\nsection 29(1);\n(b) directives expressly allowing the use of a practice for which a\nhealth care decision maker would otherwise have no authority\nto consent to under section 29.\n\nPart 7 Administrative and other matters\nHealth Care Decision Making Act 2023 34\n(2) The Senior Practitioner may approve the use, for a particular adult,\nof a practice to which a health care decision maker has no authority\nto consent under section 29, with or without conditions.\n54A Delegation\n(1) The Senior Practitioner may delegate the Senior Practitioner's\npowers and functions under this Act to a public sector employee.\n(2) The Senior Practitioner must be satisfied that the employee has the\nqualifications, clinical experience and personal qualities necessary\nto exercise the Senior Practitioner's powers and perform the Senior\nPractitioner's functions.\n55 Public Guardian guidelines\nThe Public Guardian may make guidelines for this Act in relation to\nthe following:\n(a) how to apply and interpret section 13, including determining\nthe appropriate health care decision maker when more than\none person may be the appropriate health care decision\nmaker;\n(b) satisfying the duty of a health care provider under section 23;\n(c) determining capacity under section 24;\n(d) administering routine health care under section 25;\n(e) making health care decisions generally under this Act.\n56 Report to Public Guardian\nA health care provider must give written notice to the Public\nGuardian of any instance when:\n(a) the health care provider is aware of the health care decision\nmaker refusing to consent to significant treatment for an adult\nwith impaired decision making capacity; and\n(b) the health care provider believes on reasonable grounds that\nthe health care decision maker does not know, and cannot\ninfer, the wishes and views of the adult with impaired decision\nmaking capacity.\nNote for section 56\nThe Public Guardian has powers under the Guardianship of Adults Act 2016 to\ntake action if appropriate in the circumstances.\n\nPart 8 Repeal\nHealth Care Decision Making Act 2023 35\n57 Liability of health care providers\nA health care provider who, in good faith and without negligence,\nadministers or does not administer health care to a person in\naccordance with this Act and believes on reasonable grounds that\nthe requirements of this Act have been complied with is not:\n(a) guilty of an offence; or\n(b) liable for unprofessional conduct or professional misconduct;\nor\n(c) liable in any civil proceeding; or\n(d) liable for contravention of any code of conduct.\n58 Regulations\n(1) The Administrator may make regulations under this Act.\nNote for subsection (1)\nSee section 65 of the Interpretation Act 1978.\n(2) The Regulations may apply, adopt or incorporate, with or without\nchanges, the whole or part of a document as in force or existing at\na particular time or from time to time.\nPart 8 Repeal\n59 Act repealed\nThe Emergency Medical Operations Act 1973 (Act No. 45, 1973) is\nrepealed.\n\nENDNOTES\nHealth Care Decision Making Act 2023 36\nENDNOTES\n1 KEY Key to abbreviations\namd = amended od = order\napp = appendix om = omitted\nbl = by-law pt = Part\nch = Chapter r = regulation/rule\ncl = clause rem = remainder\ndiv = Division renum = renumbered\nexp = expires/expired rep = repealed\nf = forms s = section\nGaz = Gazette sch = Schedule\nhdg = heading sdiv = Subdivision\nins = inserted SL = Subordinate Legislation\nlt = long title sub = substituted\nnc = not commenced\n2 LIST OF LEGISLATION\nHealth Care Decision Making Act 2023 (Act No. 19, 2023)\nAssent date 17 August 2023\nCommenced 1 July 2024 (Gaz G13, 20 June 2024, p 2)\nAttorney-General Legislation Amendment Act 2025 (Act No. 14, 2025)\nAssent date 6 June 2025\nCommenced 1 August 2025 (Gaz G14, 10 July 2025, p 1)\n3 LIST OF AMENDMENTS\ns 54A ins No. 14, 2025, s 4\npt 9 hdg rep No. 19, 2023, s 110\npt 9\ndiv 1 hdg rep No. 19, 2023, s 110\npt 9\ndiv 1\nsdiv 1 hdg rep No. 19, 2023, s 110\nss 60 – 75 rep No. 19, 2023, s 110\npt 9\ndiv 1\nsdiv 2 hdg rep No. 19, 2023, s 110\nss 76 – 78 rep No. 19, 2023, s 110\npt 9\ndiv 2 hdg rep No. 19, 2023, s 110\npt 9\ndiv 2 rep No. 19, 2023, s 110\nsdiv 1 hdg rep No. 19, 2023, s 110\nss 79 – 86 rep No. 19, 2023, s 110\npt 9\ndiv 2\nsdiv 2 hdg rep No. 19, 2023, s 110\nss 87 – 88 rep No. 19, 2023, s 110\n\nENDNOTES\nHealth Care Decision Making Act 2023 37\npt 9\ndiv 3 hdg rep No. 19, 2023, s 110\nss 89 – 100 rep No. 19, 2023, s 110\npt 9\ndiv 4 hdg rep No. 19, 2023, s 110\nss 101 – 102 rep No. 19, 2023, s 110\npt 9\ndiv 5 hdg rep No. 19, 2023, s 110\nss 103 – 109 rep No. 19, 2023, s 110\npt 9\ndiv 6 hdg rep No. 19, 2023, s 110\ns 110 rep No. 19, 2023, s 110","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"The Act replaces the Emergency Medical Operations Act 1973 (s59) and establishes a consolidated statutory scheme for health care decision‑making for adults with impaired capacity (s3). It broadens and formalises a decision‑maker hierarchy to include advance appointees and guardians (s3(b), s13), creates explicit urgent‑care rules for adults and children (Part 4, s38–39), adds tribunal oversight and powers to disregard advance decisions (s41), and creates new criminal offences and administrative roles (Part 6; s22; s54)."},"complexity_factors":["Multi‑tier hierarchy and eligibility criteria for decision‑makers (s13, s14) creating potential disputes about who decides.","Dual standards for decisions: give effect to advance statements or, failing that, substituted judgment, then best interests (s18(2)–(9)).","Broad list of restricted and excluded interventions with carve‑outs and tribunal approval routes (s29, s30, s41(1)(d)–(e)).","Urgent‑care override for adults and children that displaces ordinary consent rules (Part 4; s38–39).","NTCAT original jurisdiction, closed proceedings and power to disregard advance decisions introduce specialised review processes (s40–45).","Criminal offences and high penalties, including strict liability elements and limitation period rules, raise enforcement complexity (Part 6; s46–53).","Interplay with other statutes (Advance Personal Planning Act 2013; Guardianship of Adults Act 2016; Mental Health and Related Services Act 1998) requires cross‑referencing (s3(b), s11(2), s36).","Administrative roles and guidance obligations (Public Guardian s22, s55; Senior Practitioner s54, s54A) create delegated discretion and implementation variability.","Operational duties and provider protections (duty to search for advance consent s23; good faith protection s57) affect clinical workflow and compliance burden."],"plain_english_summary":"This Act creates a legal framework for who can consent to health care when an adult cannot make decisions. It sets a priority list of decision‑makers (including advance appointees and guardians), explains how they must decide (including substituted judgment and best‑interests tests), limits certain treatments, allows urgent care without consent in emergencies, and gives NTCAT powers to resolve disputes. It affects adults with impaired capacity, their families/carers, health care providers, the Public Guardian and NTCAT; providers must check advance plans and follow duties and safeguards (see s23, s18, Part 4)."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"issue_detection":{"absurdities":[],"contradictions":[]},"kimi_summary":{"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"The legislation appears consistent with its original intent as stated in section 3: governing health care decisions for adults with impaired capacity, providing for urgent health care without consent, and establishing decision-making principles. The scope has not expanded beyond these purposes."},"complexity_factors":["59 sections across 8 Parts with extensive cross-referencing to other NT legislation (Advance Personal Planning Act 2013, Guardianship of Adults Act 2016, Mental Health and Related Services Act 1998, etc.)","Nested conditional logic in decision-making principles (section 18): primary obligation to follow advance care statements, then substituted judgment (what the person would want), then best interests, with multiple exemptions in section 20","Complex hierarchy of decision makers (section 13) with 9 tiers and special rules for multiple appointees (section 15), relinquishment (section 16), and Public Guardian fallback (section 22)","Detailed restrictions on authority with multiple exceptions: section 29 (restrictive practices) has 6 categories of prohibited practices but 6 categories of exceptions; section 30 (restricted health care) lists 8 prohibited procedures with 2 conditional exceptions","Interaction between Parts 2, 3, and 4 creating conditional precedence rules (section 38 states Part 4 prevails over inconsistent provisions in Parts 2 and 3)","Multiple fault elements and strict liability provisions in offences (Part 6) requiring careful parsing of mental states (intention, recklessness, knowledge) and evidential burdens","Defined terms scattered throughout (sections 4-9) with some terms defined by reference to other Acts (e.g., 'complex cognitive impairment' refers to Mental Health and Related Services Act 1998)","Specific procedural requirements for NTCAT proceedings including closed proceedings (section 43), oral reasons (section 44), and exclusion of internal review (section 45)"],"plain_english_summary":"**What this law does:**\n\nThis Act sets up a system for making medical decisions for adults in the Northern Territory who can't make those decisions for themselves due to impaired decision-making capacity. It creates a clear hierarchy of who can speak for the person, establishes rules for how decisions must be made, and provides protections for both patients and health care providers.\n\n**Who it affects:**\n\n- **Adults with impaired capacity** – people who can't understand, retain, weigh up, or communicate health care decisions (for example, due to dementia, brain injury, or severe mental illness)\n- **Family and friends** – they can become \"health care decision makers\" based on a priority list: appointed decision-makers first, then guardians, then culturally appropriate relatives, spouses/partners, carers, children, parents, siblings, and finally close friends\n- **Health care providers** – doctors, nurses, and other health workers who must follow these rules when treating patients who lack capacity\n- **The Public Guardian** – a government official who steps in when no one else is available or appropriate\n\n**Key things the law covers:**\n\n- **Decision-making hierarchy:** A ranked list of who can make decisions when someone can't (Part 2)\n- **Substituted judgment standard:** Decision makers must try to figure out what the person *would have wanted*, not just what's \"best\" for them medically\n- **Advance care planning:** Recognises decisions people made in advance when they had capacity\n- **Restricted procedures:** Bans decision makers from consenting to certain things like sterilisation, termination of pregnancy, or experimental treatments (with limited exceptions)\n- **Restrictive practices:** Limits the use of restraints, seclusion, and chemical restraint unless specifically approved\n- **Urgent care:** Allows doctors to treat people without consent in emergencies to save life or prevent serious harm\n- **NTCAT oversight:** The Northern Territory Civil and Administrative Tribunal can resolve disputes and override decisions\n- **Offences:** Criminal penalties for people who falsely claim authority, misuse their power, or provide misleading information\n\n**Why it matters:**\n\nThis law balances autonomy (respecting what the person would have wanted) with protection (preventing abuse or neglect). It gives families clear authority while setting boundaries on what can be decided without court oversight. It also protects health workers from liability when they act in good faith under the Act."}},"importantCases":[],"_links":{"self":"/api/acts/health-care-decision-making-act-2023","history":"/api/acts/health-care-decision-making-act-2023/history","analysis":"/api/acts/health-care-decision-making-act-2023/analysis","conflicts":"/api/acts/health-care-decision-making-act-2023/conflicts","importantCases":"/api/acts/health-care-decision-making-act-2023/important-cases","documents":"/api/acts/health-care-decision-making-act-2023/documents"}}