What is an Advance Health Care Directive?

An Advance Health Care Directive is a legal document that tells your health care providers and loved ones what your health care wishes are in the event that you are unable to speak for yourself. It allows you to appoint a person as your Substitute Decision Maker to communicate your wishes if, for some reason, you are unable to do so. An Advance Health Care Directive can help prevent conflicts with respect to what treatments you should or should not receive according to your wishes. Your lawyer can help you make sure that the terminology used in your Advance Health Care Directive is clear and follows the current legal requirements in relation to Advance Health Care Directives in the Province of Newfoundland and Labrador.

What should I include in my Advance Health Care Directive?

Your Advance Health Care Directive must include the date it was signed, your signature, and you must have two people witness your signature. Your witnesses can not be your Substitute Decision Maker or your Substitute Decision Maker’s spouse. Your Advance Health Care Directive should name a person to act as your Substitute Decision Maker and should clearly set out your instructions and wishes regarding any potential health care treatments. Some examples of your instructions regarding treatments that may be included in your Advance Health Care Directive are:
Heart resuscitation;
Radiation or Chemotherapy treatments;
Artificial breathing mechanisms;
Dialysis treatments;
Blood transfusions;
Pain relief medications.

Who is a Substitute Decision Maker?

A Substitute Decision Maker is a person who is over the age of 19 who will follow the instructions you have set out in your Advance Health Care Directive in the event that you are unable to speak for yourself. If you do not have any written instructions, your Substitute Decision Maker will follow any verbal wishes you may have expressed while you were able to do so. If you have not expressed your wishes to anyone regarding a specific type of treatment, your Substitute Decision Maker will do what they believe to be in your best interests. Because of this, it is very important that your Substitute Decision Maker be a person that you trust and understands your health care wishes.

Can I appoint more than one Substitute Decision Maker?

Yes. You can appoint multiple people as your Substitute Decision Makers. You can specify that these individuals can only act as a group, or that they may also act without the input of the other named Substitute Decision Makers. If you require your Substitute Decision Makers to only act as a group, you should consider the issues that may arise if not all of your Substitute Decision Makers live in the same place. Obtaining information from multiple people when not all of them are present may cause a delay that could endanger your life. You can also name an alternate Substitute Decision Maker, who would take the place of the first Substitute Decision Maker in the event that he or she is unable or unwilling to act.

Why should I have an Advance Health Care Directive?

An Advance Health Care Directive is important because it allows you to express your wishes to your loved ones and health care providers in the event you cannot speak for yourself. It also allows you to express your wishes regarding specific treatments, as well as general types of treatment. If you do not have an Advance Health Care Directive, your health care providers may use treatments that you do not agree with or would not choose. When you have an Advance Health Care Directive your wishes must be followed thus reducing the risk of conflict arising between your loved ones regarding your treatment.

What if there is an emergency?

Health care providers can administer treatments to save your life, even if this goes against your wishes, but ONLY IF the delay in contacting your Substitute Decision Maker would be a significant risk to you. In most cases, your health care provider will make efforts to contact your Substitute Decision Maker prior to taking any action.

Can I include instructions regarding Medically Assisted Death?

No. Right now, the law does not allow individuals to plan in advance for the use of Medically Assisted Death.
Where should I keep my Advance Health Care Directive?
You should always keep your Advance Health Care Directive in a safe place. This may be in a fireproof safe, a safety deposit box, or some other secure location. You should also provide copies of your Advance Health Care Directive to your Substitute Decision Maker(s), your doctor, and your family members.