In Ontario, advance care planning (ACP) is
- Confirming your substitute decision maker(s) (SDMs); and
- Communicating your wishes, values and beliefs about care to help your SDM(s) make health and personal care decisions for you if you become mentally incapable of doing so for yourself.
Why is this Important?
In Ontario, the law requires all health care providers to get informed consent, or refusal of consent, before providing a patient with any treatment or care. Health practitioners must tell you about your illness and what may be done to treat you. You then have the right to make a decision and agree to or refuse the treatments offered. This is called health care consent: it is a basic patient right to decide what health care to receive.
Only in emergencies, to save a life or to reduce suffering, can people be treated without informed consent. Consent always comes from a person: either the mentally capable person or their substitute decision maker(s).
If you are not mentally capable, the health practitioner will turn to another person, your substitute decision maker, who will then speak for you and make the decision about your care. Advance care planning lets you know who would speak for you.
Advance care planning is not about decisions. It is about preparing you,and your future substitute decision maker(s), for a time when you may not be able to make your own health or personal care decisions because of your lack of mental capacity. At that time, your future SDM would step in to give or refuse consent for treatment.
Person-centred decision-making involves incorporating patient perspectives, priorities and goals throughout an illness trajectory from advance care planning through to treatment discussions and informed consent.