Most people prefer not to think about it: an accident, a severe stroke or advanced dementia – and suddenly you are no longer able to make your own decisions. Who then speaks for you and which treatments are carried out depends largely on whether you have made provision in advance. With an advance healthcare directive and an enduring power of attorney, you can determine in a legally secure way how your medical care should look in such a situation in Austria.
Why advance planning matters
Without an advance healthcare directive and an enduring power of attorney, doctors must decide based on what they presume the patient would have wanted. Relatives do not automatically have the right to act on your behalf – not even spouses or adult children in every case. In the worst case, the court appoints an adult representative who may be unknown to you.
Those who plan ahead retain control over key decisions in life. The advance healthcare directive and the enduring power of attorney complement each other: one regulates which medical measures should be taken, the other determines who decides on your behalf.
The advance healthcare directive in Austria
The advance healthcare directive in Austria is governed by the Patient Directive Act (PatVG). It is a written declaration of intent with which you can refuse certain medical treatments for the future – in the event that you are no longer capable of understanding and judgement.
Binding and non-binding directives
The law distinguishes between two forms:
- Binding advance directive: This is legally binding for medical staff. The requirements are detailed medical counselling, a concrete description of the treatments refused, and execution before a legally qualified person (notary, lawyer or patient advocacy organisation). Under current law it is valid for eight years and should then be renewed.
- Non-binding (informative) advance directive: This does not fulfil all formal requirements but indicates the patient's wishes. Doctors must take it into account when making decisions. The more precisely it is drafted and the closer it comes to legal requirements, the greater its weight.
What can be regulated?
Among other things, you can use an advance directive to specify whether you refuse
- mechanical ventilation,
- resuscitation,
- artificial nutrition via a feeding tube,
- dialysis treatments, or
- specific intensive care measures
in defined situations. It is important that the description is medically comprehensible and refers to specific clinical situations – general wording such as "no life-prolonging measures" is not sufficient for a binding directive.
The enduring power of attorney
While the advance directive regulates treatments, the enduring power of attorney authorises a person you trust to act in your name as soon as you are no longer able to make decisions yourself. It is regulated in the Austrian Civil Code (ABGB) and has been significantly strengthened since the 2nd Adult Protection Act of 2018.
Who can be authorised?
You can appoint any trustworthy adult as your authorised representative – for example a spouse, children, siblings or close friends. The person must agree to take on the role.
Which areas can an enduring power of attorney cover?
- Medical treatments and care decisions
- Financial affairs (e.g. banking, contracts)
- Representation before public authorities
- Decisions on place of residence (e.g. moving to a care home)
For the enduring power of attorney to take effect, it must be drawn up before a notary, lawyer or adult protection association and registered in the Austrian Central Register of Representations (ÖZVV). The activation of the power of attorney – that is, the onset of incapacity to make decisions – is triggered by a medical certificate.
Step by step: how to proceed
If you want to make self-determined decisions, you should approach advance planning calmly and with good information:
1. Clarify your own values: Consider what is important to you at the end of life. What quality of life is acceptable to you? Which measures do you reject?
2. Medical consultation: Have a doctor explain possible disease courses and treatment options. This is a prerequisite for a binding advance directive.
3. Choose a person of trust: Speak openly with the person you would like to appoint as your representative. They should know your values.
4. Legal execution: Make an appointment with a notary, lawyer, patient advocate or adult protection association.
5. Store the documents: Keep the originals in a safe place. Your GP, the authorised person and close relatives should receive a copy. Advance directives can also be stored in the ELGA system.
6. Review regularly: Update your directives every few years or after significant life events.
Frequently asked questions
What does it cost to set up?
Costs vary depending on the provider. Patient advocacy offices and adult protection associations often offer affordable or graduated fees. Notaries or lawyers charge fees according to the effort involved. Comparing providers can be worthwhile.
Can I revoke my directive?
Yes, at any time. As long as you are capable of understanding and judgement, you can change or revoke an advance directive and an enduring power of attorney. A currently expressed verbal wish also takes precedence over an earlier written directive.
What happens without advance planning?
Without advance planning, the court may order a judicial adult representation. Close relatives are considered first as elected or statutory adult representatives – but only within a legally defined framework and under judicial supervision.
Deciding for yourself – even in a crisis
Advance planning documents are not an admission of weakness, but an expression of responsible self-care. They relieve relatives in an already stressful situation, because difficult decisions do not have to be made spontaneously. And they give you the assurance that your values and wishes will be respected even when you can no longer express them.
Those who address advance directives and enduring powers of attorney early on gain a measure of peace of mind – for themselves and for those close to them.
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This article does not replace medical advice.