Decision‑making principles (s 4). These are the primary normative constraint on every person exercising powers under the Act. They require facilitation of support to enable the protected person to participate, prioritise the protected person’s wishes as far as they can be worked out unless doing so would significantly harm the protected person’s interests, promote the person’s interests where wishes cannot be worked out, apply minimal interference with the person’s life, and encourage self‑care and community participation (s 4(2), (5)-(7)). The decision‑maker must consult each carer unless the consultation would, in the decision‑maker’s opinion, adversely affect the person’s interests (s 4(3)-(4)).
Impaired decision‑making ability (s 5). The statutory trigger for the Act is impairment arising from a physical, mental, psychological or intellectual condition or state, whether or not the condition is a diagnosable illness. Section 6A limits findings of impairment explicitly where the person is merely eccentric or expresses certain political, religious or sexual views, or engages in unlawful or immoral conduct (though the Act permits effects of drugs to be taken into account).
Interests (s 5A). The Act defines a person’s interests to include protection from physical or mental harm, prevention of deterioration, capacity to look after themselves, live in the community and maintain preferred lifestyle (except parts harmful to the person), promotion of financial security, and prevention of wasting of financial resources (s 5A(a)-(e)). These statutory interests are the reference point for the decision‑making principles and for ACAT’s evaluation of whether appointment is necessary (s 7(1)(c)).
Guardians and managers (ss 7-9, 11). ACAT may appoint a guardian for health or welfare matters, and a manager for property/financial matters, if satisfied statutory thresholds (impairment, need or risk, real detriment if no appointment) are met (ss 7(1), 8(1)). ACAT must consider whether provision of support would negate the need for appointment (ss 7(2), 8(2)). Appointments must be no more restrictive than necessary (s 11). The Act prescribes who may be appointed (public trustee and guardian, trustee companies, individuals) and limits the public trustee’s appointment when an otherwise suitable individual consents (s 9(4)-(5)).
Health attorney and consent without formal representation (Part 2A, s 32A-32P). For adults with impaired decision‑making capacity who have not appointed an enduring attorney for medical consent and for whom ACAT has not appointed a guardian with medical consent powers, a specified set of persons (domestic partner, carer, close relative or close friend) are health attorneys in priority order (s 32B). Health professionals may ask the health attorney they reasonably believe best able to represent the protected person to consent (s 32D). Health professionals must provide substantial information (s 32G). Protections from civil and criminal action exist for health attorneys and health professionals acting in good faith (ss 32K-32L). Special notice/approval procedures exist where consent involves mental health treatment under the Mental Health Act 2015 (s 32JA).
Medical and low‑risk research (Part 2B). Guardians may consent to a protected person participating in approved low‑risk research (s 33) and, under a higher test, may consent to participation in medical research if the guardian is satisfied specified benefit/risk tests are met and an independent doctor has assessed the likelihood of regaining capacity when relevant (s 34(2), s 36). Guardians and health attorneys must not accept fees or be connected to research (ss 35, 32P).
ACAT supervisory and interlocutory powers (ss 12, 16-19, 62-66). ACAT registers interstate appointments (s 12), may give directions to guardians/managers (s 16) and issue binding opinions/advice (s 18). ACAT must review appointments at least every 3 years (s 19(2)) and has powers regarding enduring powers of attorney (s 62). The tribunal may order compensation for failures by guardians/managers (s 19A) and refer matters to the Supreme Court (s 19D).
Property management and financial controls (ss 21-27AA). Managers may pay for maintenance and dependants from property (s 21), receive income and realisation proceeds (s 22), must invest within Trustee Act limits or by ACAT order (s 24), lodge land titles notices within 14 days (s 25), file prescribed accounts with the public trustee and guardian (s 26), and be subject to examination and disallowance of items (s 27). The public trustee and guardian has specific accounting duties when appointed (s 27AA).
Emergency and enforcement (ss 67-68, 70-72, 74). The ACAT can make emergency orders without a hearing for up to 10 days (s 67). A president or judicial officer can issue a warrant authorising the public trustee and guardian and police to enter premises and remove a person where urgent risk is found (s 68). ACAT may consent to prescribed medical procedures for people declared not competent where best‑interests tests are met (s 70). ACAT injunctions can restrain property dealings where grounds for manager appointment exist (s 72). Corporate executive officers face criminal liability where corporations offend and the officer was reckless and failed to take reasonable preventive steps (s 74).
Interoperation with other statutes. The Act explicitly cross‑references and defers to other Acts for certain definitions and limits , for example the Powers of Attorney Act 2006 on enduring powers and decision‑making capacity (s 8B, Pt 3 definitions), the Mental Health Act 2015 for mental health treatment matters (s 7(4)(f), s 70A), the Public Trustee and Guardian Act 1985 for overlapping powers in relation to missing persons (s 8AA(2), s 30A), and the Medical Treatment (Health Directions) Act 2006 where health directions exist (s 32D note, s 8B). The Act also links to the Variation in Sex Characteristics (Restricted Medical Treatment) Act 2023 in relation to certain prescribed procedures (s 70(1) note).