Self‐binding directives for mental health treatment: when advance consent is not effective consent

Katrine Del Villar and Christopher J Ryan
Med J Aust 2020; 212 (5): . || doi: 10.5694/mja2.50505
Published online: 16 March 2020

Variation in Australian law concerning self‐binding directives for mental illness is unnecessarily complex for clinicians

Self‐binding directives (SBDs, also referred to as Ulysses directives)1 are a type of advance health directive used by people with mental illness to bind themselves to future treatment that is likely to be resisted at the time when it is needed. SBDs offer the potential to use the individual's past experience of illness to describe early indicators of the onset of another acute phase of illness,2 and give advance consent to specified forms of mental health treatment. This treatment is intended to occur at a time when the person considers their functioning will have become severely affected by illness, which may be before they meet the criteria for involuntary treatment under mental health laws.

  • Katrine Del Villar1
  • Christopher J Ryan2

  • 1 Queensland University of Technology, Brisbane, QLD
  • 2 Sydney Health Ethics, University of Sydney, Sydney, NSW


Competing interests:

No relevant disclosures.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.