What is a substitute decision-maker?

A substitute decision-maker is someone who makes decisions on your behalf if you become incapable of making them yourself.

Who can be a substitute decision-maker?

You can choose to appoint anyone who is willing and able to act on your behalf to be your substitute decision-maker except:

• someone who is paid to provide you with personal care e.g., your nurse, unless this person is your spouse, partner or relative,

• someone who is mentally incapable,

• someone who is under 16 years of age.

It is likely you will want to choose someone close to you, whom you trust and who knows you well. It is important that you discuss your intent to name the person ahead of time to make sure they are willing to act for you if it becomes necessary.

What is the role of a substitute decision-maker?

If you become unable to make decisions, your doctor or other health care providers must contact your substitute decision-maker to seek their consent before your doctor or other health care provider can give you treatment.

An exception would be an emergency situation where a health care provider may not know your wishes and may have to act quickly. However, health care providers have to follow your wishes, if they know what they are, in any and all emergency situations.

Your substitute decision-maker must try to make the same personal care choices that you would have made in that situation, and follow your instructions if you gave any. He or she acts for you only when you are unable to make decisions yourself. That situation could be temporary, or it could last for the rest of your life.

Your substitute decision-maker must:

• maintain contact with you, involving you as much as possible in any decision about your care,

• get all the relevant information from health care providers about your medical care and treatment,

• follow your known care wishes as much as possible in making any decisions that come up about your personal care.

For some decisions, you may not have given any instructions or your substitute decision-maker may not know of any wishes you have that might apply. In that case, your substitute decision-maker must consider your values and beliefs, weigh the probable benefits and risks of any course of action, and make decisions based on what he or she believes to be in your best interests.