Why share your wishes, values and beliefs with your family and friends if only your SDM can make decisions for you?
Your SDM may need help or support with making a decision on your behalf. If your family and friends know your wishes, values and beliefs, they can help your SDM make a decision. You are not required to share your wishes with anyone other than your future SDM, but think about whether it would help your SDM for others to know. In addition, your SDM may not be available to make a decision at the time it is needed, in which case the decision will go to the next person in the hierarchy who meets the requirements of an SDM. That person will need to make a decision for you and will need to know your wishes.
What happens in an emergency if I cannot communicate and the hospital does not know who my substitute decision maker Is?
In an emergency, there may be no time to get consent from anyone. In that case, health providers have the authority to treat you without consent if it is necessary to relieve any pain or suffering or to address any risk of serious bodily harm. If your health providers know of any wishes you have expressed about your care, they must honour those wishes. Once you are stable, the health care providers will need to determine who your SDM is (automatic or person named in POAPC) so your SDM can make ongoing health decisions for you until you are capable of doing so for yourself.
It is important to confirm your SDM and engage in those conversations now — while you are well.
Make sure your family and friends know who will act as your substitute decision maker.
Your SDM will likely be contacted if an emergency occurs. You can carry a wallet card* (see page 19) that identifies your substitute decision maker(s) and their contact information. Communicate to those close to you where you have stored any important documents. It is also important to share your wishes, values and beliefs with your family and friends (not just your future SDM) so they can support your SDM.
I have a “living will”. Is that good enough?
In Ontario, the law does not use terms such as “living will” or “advance directive” and there is no requirement to record your wishes. A “living will” is commonly thought of as a document in which you list your wishes about medical treatments. However, the law does state that a person can express wishes about their future care orally, in writing or by any alternative means. You can set out your wishes in a written document or “living will”. Anyone that acts as your substitute decision maker is required to follow your wishes about treatment, if known, however expressed, even if described in a “living will”. The “living will” has no particular “form” in Ontario and does not need to be witnessed or signed.
You cannot appoint someone to act as your substitute decision maker in a “living will” or any other written document. In Ontario, you can only appoint a substitute decision maker through a Power of Attorney for Personal Care.