The Substitute Decision Maker Hierarchy in Ontario

Did you know that everyone in Ontario has a SDM even if he or she has never prepared a Power of Attorney for Personal Care appointing someone to act in that role? The Health Care Consent Act includes a hierarchy of SDMs that includes:

  • three different types of SDMs that get authority through different types of legal processes,
  • family members that get authority to automatically act as SDMs without being appointed – you don’t have to do anything; and
  • an SDM of last resort.

The person, or persons, in your life ranked highest in the substitute decision maker hierarchy who meet(s) the requirements to act as a substitute decision maker will be your SDM(s) for health care. See next page a detailed description of the hierarchy.