Palliative care plans and AI security: what an end-of-life plan gives away in ChatGPT or Claude.

A palliative care plan is written once and read many times, by the night nurse, the on-call doctor, the priest and a daughter who is staying in the room. That is why staff ask ChatGPT or Claude to tidy it, turn it into a one-page summary or translate it for family. It holds a prognosis, what the resident has decided about resuscitation, the drugs that keep her comfortable, her faith and language, a disagreement between her children and what she wants done after she dies. This page marks every item in a realistic plan and shows what the Aged Care Act 2024, the Privacy Act and NSW law bear on, and how the same plan is summarised on Ermos.

The palliative care plan

Prepared when a resident’s condition becomes terminal, by the registered nurse with the GP and the resident’s representative, and reviewed on any change in condition.

Kurrajong Gardens Aged Care
Palliative care plan and end-of-life wishes · Reviewed 19 October 2026 · Review again on any change in condition

Resident
Diagnosis and outlook
Goals of care
Advance care directive
Symptom plan
Routine comfort care
Language, faith and culture
Family
After death
Plan prepared by

An invented plan. Phone numbers are placeholders. Hover or tap any highlighted item for the analysis; the full list is below.

What leaves the service

  1. 1
    The resident

    A named woman, her room and her date of birth. Personal information that section 23(5) (the Statement of Rights) and section 168 of the Aged Care Act 2024 say the provider must protect. Privacy Act guide.

  2. 2
    Diagnosis and outlook

    A cancer diagnosis and a doctor’s estimate of how long she has. Health information is sensitive information under the Privacy Act, and a prognosis is among the most guarded things a service holds. Her family may not have heard it in these words. Patient data guide.

  3. 3
    Goals of care and the hospital decision

    What the resident wants and the point at which she should be sent to hospital. Palliative care is one of the clinical topics under Standard 5 of the Aged Care Quality Standards, according to the Commission, and this decision is the one the plan exists to protect. Patient data guide.

  4. 4
    The advance care directive

    Her instructions on resuscitation, intensive care and feeding. NSW Health says an advance care directive is legally binding, must be made by a person with decision-making capacity, and cannot be overridden by a guardian or person responsible. Staff should work from the signed document, and a summary of it is a second copy of the most consequential page in the file. Patient data guide.

  5. 5
    Symptom plan and medicines

    Opioids, a syringe driver, her weight and an allergy. Health information, and orders that belong to the doctor. A tool can rephrase a drug plan wrongly, so a clinician must check anything it produces against the orders. Patient data guide.

  6. 6
    Language, faith and culture

    Her first language, her religion and the priest. Religious beliefs are on the Privacy Act’s closed list of sensitive information, and a first language can point to racial or ethnic origin, which is on it too. They are recorded so staff can arrange an interpreter and a priest, and that is the purpose they may be used for. Privacy Act guide.

  7. 7
    A disagreement between her children

    A son’s wish for hospital, a daughter’s refusal and the reason. NSW Health lists an appointed guardian, including an enduring guardian, first among the persons responsible. It is a family confidence, and the personal information of two people who are not residents. Privacy Act guide.

  8. 8
    Wishes after death, the funeral and the will

    What the family will do, where the funeral plan is and who holds the will. Financial and family detail that no stranger needs, and nothing a draft should be allowed to guess at. Privacy Act guide.

  9. 9
    The people who made the plan

    A named nurse, a named doctor and the guardian. Each has professional or legal responsibilities, and the Aged Care Code of Conduct, which a registered provider must comply with as a condition of registration, also applies directly to its aged care workers. Privacy Act guide.

  10. 10
    Routine comfort care wording

    The standard wording of the facility’s procedure. It names no one and says nothing about this resident. It can go anywhere.

What happens in Frontier Models (ChatGPT, Claude)

  • The whole document is transmitted to the provider’s servers. On personal plans the user cannot choose where it is stored or processed, and for the major providers that has generally meant outside Australia, under that country’s legal process. Some business plans offer storage in Australia, but the provider still receives the content.
  • On consumer tiers, prompts can be retained and used to train future models.
  • The provider’s staff and systems can reach the content under the provider’s own policies.
  • Once sent, the service no longer controls it. Retention and deletion happen on the provider’s terms.

The same document on Ermos

Ermos Dominion

The document is drafted on a unit in your office, from your own templates and the resident’s record. Every marked item stays on the unit, which keeps working with the internet switched off. Nothing in it is transmitted to an AI provider, so there is no disclosure to analyse: the confidentiality work is the same as for your file server.

Ermos Edge

Your documents, the index and your access boundaries stay on your own instance in an Australian data centre. When a staff member asks for this draft, only their question and the excerpts they are permitted to see go to a named Australian provider, who is contractually barred from keeping the content or training any model on it. Nothing is processed outside Australia.

Frontier Models (ChatGPT, Claude)Ermos EdgeErmos Dominion
Where the document is processedProvider servers, generally offshore on personal plansYour instance in an Australian data centre; answers generated in AustraliaThe unit in your office
Who can read itProvider staff and systems, under policyYour staff, within the boundaries you set. The named Australian provider processes only permitted excerpts, under contract, and keeps nothingYour staff only
Is it keptOn the provider’s termsKept on your instance; the provider is barred from retaining itStays on the unit
Can it train a modelOn consumer tiers, yesNo, by contractOnly your own unit learns from it, on your hardware

Part of AI data leakage in aged care providers.

Common questions

Do ChatGPT and Claude use the information in a palliative care plan?
Anything pasted or uploaded travels to the AI company's servers and is processed there to produce a reply. As at October 2026, whether a conversation on a personal plan (ChatGPT Free, Plus or Pro; Claude Free, Pro or Max) can be used to train the models depends on a setting each user controls. Business plans (ChatGPT Business and Enterprise, Claude Team and Enterprise) and the developer APIs sit under commercial terms, and OpenAI and Anthropic each say they do not train on that content by default (OpenAI, Anthropic). On either product, the thumbs up and thumbs down buttons can send a whole conversation back for training. A plan like this holds Mei-Ling Chau's prognosis of weeks rather than months, her no-CPR directive, a syringe driver plan and a disagreement between her son and daughter.
Is it safe to paste a palliative care plan into ChatGPT or Claude if we remove the names?
No, because the plan describes her without a name. Removing names rarely makes a document anonymous. Information stays personal information while the person is reasonably identifiable, and the OAIC warns that information can be at risk of re-identification even when it has been de-identified or anonymised. An 88-year-old Roman Catholic woman whose first language is Cantonese, with metastatic breast cancer, a daughter who is her enduring guardian and a son in Singapore, is one person. The Office of the Australian Information Commissioner (OAIC) recommends in its guidance on commercially available AI products that organisations do not enter personal information, and particularly sensitive information, into publicly available generative AI tools, because of the significant and complex privacy risks.
Does deleting the chat remove a palliative care plan from ChatGPT or Claude?
Not with certainty. Deleting a chat removes it from the user's history, but OpenAI and Anthropic each say they can keep a deleted chat on their systems for up to 30 days, and longer where safety or legal obligations apply (OpenAI, Anthropic). The prognosis, the advance care directive and the family disagreement are the parts of this plan a service would least want on a third party's systems for that period, while the family is still sitting in the room.
How can an aged care service use AI for a palliative care plan without sending it to ChatGPT or Claude?
Ermos is built so the document stays under your control. On the Dominion AI unit it is drafted inside your office and none of it is sent to an AI provider. On Ermos Edge your documents and index stay on your own instance in an Australian data centre, and only the question and the excerpts the user is permitted to see go to a named Australian provider that is contractually barred from keeping them or training any model on them. Ermos prepares the one-page summary from the resident's file and the service's own palliative care procedure. A registered nurse checks it against the signed directive and the doctor's orders before anyone uses it.
Is an advance care directive legally binding in NSW?
NSW Health says an advance care directive is legally binding, can be spoken or written, and must be made by a person with decision-making capacity. It says a guardian or person responsible cannot override it and that it takes effect only when the person lacks capacity. An advance care plan made for someone with limited capacity is not legally enforceable. A service should hold the signed document and not rely only on a summary.
Who decides when the resident can no longer decide?
In NSW the person responsible for medical decisions is ranked, and NSW Health lists an appointed guardian, including an enduring guardian, first on that list, then a spouse or partner, a carer, and a relative or friend. Next of kin is not a category on that list. The plan should name the enduring guardian, record that the appointment document was seen and note any disagreement in the family. NSW Health points to NSW Trustee and Guardian for legal questions about directives.
Is religion or language in a care plan sensitive information?
Under the Privacy Act, religious beliefs and racial or ethnic origin are on the closed list of sensitive information, alongside health information, and their collection and use are more tightly limited. A first language is not on the list itself, but it can point to ethnic origin. A palliative care plan records them so staff can arrange a priest or an interpreter, and that is the purpose it is held for. Sending it to a tool outside the service is a separate question.

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