Palliative Care
Western Australia
Submission to the Community Development and Justice Standing Committee Inquiry into the Guardianship and Administration System in Western Australia
Submitted by: Palliative Care Western Australia
Date: May 2026
Introduction
Palliative Care WA is the peak body for palliative care in Western Australia, working across the health, aged care and community sectors to improve end-of-life care and advance care planning.
Our work sits at the point where decisions matter most. We support people to articulate their wishes, and we see what happens when those wishes are followed, and when they are not.
This submission is based on that experience, supported by emerging data from the WA Health Department and consistent with findings across recent submissions to this Inquiry. It focuses on how the guardianship system operates in practice, particularly at end of life, where delays, complexity and decision-making frameworks have immediate consequences.
Purpose of this submission
Western Australia has a longstanding focus on guardianship and administration, reflecting the importance of decision making at times when people may be vulnerable or unable to speak for themselves.
Palliative Care WA welcomes this Inquiry and the opportunity it provides to take a considered look at how the system is operating in practice.
This submission is not intended to be comprehensive. Rather, it is to indicate our interest in the Inquiry and to offer the perspective of the palliative care sector, which spans clinical care, aged care, community services and lived experience.
Palliative Care WA would welcome the opportunity to contribute further as the Inquiry progresses, including through hearings or consultation. Through our membership we bring the experience of clinicians, system administrators and people with lived experience and their families. Our membership also touch every section of the health, aged care and community care ecosystem.
Relevance to Palliative Care: Decision making at end of life is time critical
Decision making is central to palliative care. It often occurs in circumstances where time is limited, clinical needs are changing, and the impact of decisions is immediate.
Guardianship and administration frameworks intersect with this in a number of ways, including:
- situations where a person’s decision making capacity is changing or uncertain
- the role of substitute decision makers
- the interaction with advance care planning and other planning tools
- the practical application of decisions across different care settings
From a palliative care perspective, there is a clear link between early planning, clarity of roles, and the ability of the system to support care that aligns with a person’s preferences.
Areas of interest for the Inquiry
From our work across the sector, there are four areas that may benefit from closer consideration as part of this Inquiry.
1. Early planning and community understanding
In many cases, decision making frameworks are only engaged once a person’s condition has changed or a crisis has occurred. At that point, individuals and families are often navigating complex decisions for the first time, with limited understanding of the available tools. There may be value in considering how awareness, education and use of advance care planning and related documents like the Advanced Health Directive can be used earlier, when people are better able to articulate their preferences.
2. Decision making in time-sensitive settings
End of life care often involves decisions that need to be made within short timeframes, sometimes across different parts of the health system. This can include hospital, community and aged care settings. The way decision making frameworks operate in these environments, where clinical needs are evolving and time is limited, is an important practical consideration.
3. Roles, relationships and clarity for families and clinicians
Families and clinicians work together in supporting decision making. This involves formal roles, such as appointed decision makers, as well as informal support from family and carers. Clear understanding of roles, responsibilities and authority can make a significant difference to how decisions are made and experienced. There may be value in considering how the system supports this clarity in practice.
4. Alignment with a person’s preferences
At the centre of the system is the individual. In palliative care, this is often expressed through a person’s stated wishes about their care, their treatment preferences, and where they would prefer to be cared for. Understanding how the system supports these preferences to be known, considered and applied in practice is an important area for reflection.
Engagement and contribution
Palliative Care WA members work across hospitals, primary care, aged care and community services. Through this, we see how decision making frameworks operate across different parts of the system, including how decisions are made and communicated, how services interact, and how individuals and families experience these processes in practice.
This cross-sector perspective positions the palliative care sector to offer practical insight into how guardianship and administration arrangements operate in real-world settings, particularly at the end of life.
Palliative Care WA would welcome the opportunity to support the Committee’s work, including through hearings or roundtables, and by providing input from across clinical, community and lived experience perspectives.
This Inquiry provides an important opportunity to consider how the guardianship and administration system supports Western Australians at times of vulnerability. We look forward to engaging further with the Committee as its work progresses.