Medical Treatment Planning and Decisions Act 2016
56Record keeping requirements
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56 Record keeping requirements
(1) Before, or as soon as practicable after, administering medical treatment in accordance with this Part to a person who does not have decision-making capacity for that medical treatment, a health practitioner must record in writing in the person's clinical records—
(a) that the practitioner was satisfied that the person did not have decision-making capacity; and
(b) the reason or reasons for being so satisfied.
(2) Without limiting subsection (1), a health practitioner who forms a belief under section 51 or 59(b) must record this belief in writing in the clinical records of the person to whom medical treatment is being administered.
(3) A health practitioner who administers routine treatment to a person under section 63(1)(a) must set out in the person's clinical records details of—
(a) the practitioner's attempts to locate an advance care directive and a medical treatment decision maker; and
(b) the exact nature of the routine treatment and the reason for the decision to administer the routine treatment.
Division 2—Medical treatment decision‑making process