Psychiatric Advance Directives and Human Rights

Since the early 1990s many jurisdictions have recognised psychiatric advance directives. In Australia, reviews of mental health legislation have been completed in New South Wales and the Northern Territory, and are on foot in Western Australia, South Australia, Queensland, Tasmania, the ACT and Victoria. To date, only the ACT and Victorian reviews have seriously countenanced the legislative recognition of advance directives. In the current environment of review and debate about the proper balance between rights and risks in psychiatry, the structure of comparable international provisions and international clinical experience with psychiatric advance directives can usefully inform Australian developments. This article outlines the relevant law in Australia and the legislative approaches adopted in Scotland, England and Wales, New Zealand, Canada and the United States of America. It argues that effective law reform in Australia should attend to international precedent, but also be mindful of the deeper human rights principles represented by the psychiatric advance directive movement.