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An advance directive is a document you prepare that states what your wishes are in the event you are no longer able to make health care decisions. These directives come into effect only when you are no longer competent (for example, if you are in a coma).
Advance directives can take one of two forms: instructional or proxy.
Instructional directive
This type of directive states what (or how) health care decisions are to be made when you are unable to make these decisions for yourself. This type of directive may set out specific instructions or it may set out general principles to be followed for making your health care decisions.
Instructional advance directives are also known as "living wills".
Proxy directive
This type of directive specifies who you want to make decisions for you when you are no longer able to make the decisions yourself. Your proxy, also known as a "substitute decision-maker", should be someone who knows you well and should be someone you trust to follow your instructions and make decisions that are likely to comply with your wishes. As some provinces allow more than one person to act as a proxy, it is important to check the details in your provincial legislation. A proxy should always be asked in advance whether he or she is willing to take on the responsibility of making decisions for you.
Proxy advance directives are also known as "durable powers of attorney for health care". |
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Used with the permission of the Robert Pope Foundation
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"A doctor is not free to disregard a patient's advance instructions any more than he would be free to disregard instructions given at the time of the emergency."
Malette v. Shulman (1990), 72 O.R. (2d) 417 at 424 (C.A.). |
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"A patient, in anticipation of circumstances wherein he or she may be unconscious or otherwise incapacitated and thus unable to contemporaneously express his or her wishes about a particular form of medical treatment, may specify in advance his or her refusal to consent to the proposed treatment. A doctor is not free to disregard such advance instructions, even in an emergency. The patient's right to forgo treatment, in the absence of some overriding societal interest, is paramount to the doctor's obligation to provide medical care. This right must be honoured, even though the treatment may be beneficial or necessary to preserve the patient's life or health, and regardless of how ill-advised the patient's decision may appear to others."
Fleming v. Reid (1991), 4 O.R. (3d) 74 at 85-86 (C.A.). | |
