The Health Care Directives and Substitute Health Care Decision Makers Act

The Health Care Directives and Substitute Health Care Decision Makers Act provides that competent persons who are at least 16 years of age may make a health care directive to give instructions for the medical treatment they wish to receive if they become unable to make a health care decision.

Individuals may provide or refuse consent for future medical treatment, or they may appoint proxies to make health care decisions on their behalf in case they become unable to make these decisions themselves.

A proxy must be 18 years of age and must have the capacity to make health care decisions. Where a directive does not give directions for specific circumstances, and no proxy has been appointed or is willing or able to act, the nearest relative of the person can make a decision on his or her behalf.

Nearest relative is the first available person in the following list:

• the spouse or person with whom the person cohabits as a spouse in a relationship of some permanence;
• an adult son or daughter;
• a parent or legal custodian;
• an adult brother or sister;
• a grandparent;
• an adult grandchild;
• an adult uncle or aunt;
• an adult nephew or niece.

A directive must be in writing, dated and signed by the person and one witness who is not the proxy or the proxy's spouse. A person may revoke a directive orally, in writing, by destroying the directive, or by making a new directive.

A substitute decision-maker, whether a proxy or a nearest relative, must act according to the patient's wishes. If he or she has no knowledge of the patient's wishes, the proxy or relative must act in what he or she believes to be the patient's best interests.

When a court is satisfied a proxy or nearest relative is not acting in good faith, the court may rescind any decision made and appoint another relative to make a health care decision, or may substitute the court's decision for the decision of the proxy.