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Personal
Health Care Directive Tutorial
A personal health care directive is a document
which appoints someone to make decisions about
your health or personal care should you become
incapacitated. (A living will addresses end-of-life
medical treatment but may not appoint a decision
maker.)
Each province and state has slightly different legislation governing health care directives. Please be sure to read the current legislation for your jurisdiction. This legislation can be accessed via the internet. For example, the
Health Care Directives Act, 1992, of Manitoba
states that anyone who has capacity to make health
care decisions can make a health care directive.
A person 16 years of age or older is presumed
to have that capacity. Anyone making a directive
is presumed to be at least 16 unless the contrary
is proven. A directive must be in writing, dated
and signed. It becomes effective when the person
loses capacity or is unable to communicate his
or her wishes. The person appointed to make decisions
is called a "Proxy." A Proxy must be
at least 18 years old and must act in accordance
with the list of principles that include the following:
-
follow the directions outlined in the directive
-
follow the person's wishes
-
act in the person's best interest
A
Proxy cannot make decisions about the following
unless the directive specifically says otherwise:
-
medical treatment primarily for research
-
sterilization that is not medically necessary
for the protection of the person's health
-
removal of tissue for transplantation or research.
The
Health Care Directives Act, 1992, also contains
provisions for more than one Proxy should they
disagree. The court can review the conduct of
a Proxy and terminate or replace him or her. A
Proxy is protected from liability for actions
made in good faith and is still entitled to rights
he or she might have by a will or otherwise.
If
you wish to have a personal health care directive
in place, you need to make the following decisions:
1.
Who you wish to appoint as a Proxy. Most people
choose a spouse, partner, sibling, child, friend,
member of the clergy, or other adviser. Some people
choose two proxies, but if you do, you need to
decide whether these two proxies must always agree
and act together or whether one or the other can
make decisions.
2.
When the Proxy is to start making decisions. Who
will decide when you become incapacitated. Many
people leave that decision in the hands of their
family doctor. Some leave it to their Proxy.
3.
Your wishes concerning treatment, medications,
diet, exercise, dental care, mental health and
other health care needs.
4.
Your living arrangements, e.g. 24-hour care in
your own home or a facility or whether you want
to be separated from your spouse or partner.
5.
Social issues such as: do you want to be taken
to religious services on a regular basis; who
you want or don't want to visit you, what recreational
activities you would like to continue as long
as you are able.
6.
Legal Matters - how to handle possible disputes,
i.e. mediation or in the courts. You should also
have a power of attorney appointing someone to
make decisions about your financial affairs.
7.
There may be things you don't want your Proxy
to do. You may wish to impose requirements on
your Proxy to ensure that he or she exercises
the powers responsibly. You might want your Proxy
to report to someone or keep someone in your family
up-to-date or keep a record of any decisions.
You may wish for your competency to be reviewed
from time to time. If you have more than one Proxy
you should clarify who is to be responsible for
these requirements.
8.
Your Proxy may be a close family member or friend
who may be a beneficiary of an insurance policy
or joint owner of a residence. A good directive
should make clear that you have chosen that Proxy
even though he or she stands to gain by your death.
The directive should release the Proxy from liability
for any decisions made in good faith. This protects
your Proxy from the fear of being challenged for
carrying out your wishes.
9.
You may want to include instructions concerning
the resolution of any disputes, e.g. that they
be sent to mediation before involving lawyers
and taking the dispute to court.
10.
You should state your values and beliefs and ask
your Proxy if they are clear.
Who should know about your directive:
Your
Proxy, family doctor and family. You should carry
something in your wallet which indicates that
the personal health care directive exists. The
directive should be stored with other important
documents in safe place at home or in a safe deposit
box. Your Proxy should have access to it.
 PERSONAL
HEALTH CARE DIRECTIVE
LIVING
WILL (SIMPLE)
Canceling
your directive:
There
are at least three methods of canceling your directive:
1.
By destroying it
2.
By canceling it in writing
3.
By gesture. Should you lose your physical capacity
to speak but still have the mental capacity to
cancel your directive, you may be able to express
this wish by gestures. Some directives recognize
this by saying that you must be consulted before
any major decision is made. Such a clause in your
directive puts the onus on those who are caring
for you to be alert to any kind of communication.
A
revocation of power of attorney or renunciation
of power of attorney are available free of charge
in the Free Forms
section.
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