A one-time decision
If an adult has lost the ability to consent to health-care treatment or where they live, a health-care provider can choose one of the adult’s relatives to make the decision.
Specific decision-making is only used when there is no decision maker in place – through guardianship or an agent under a personal directive – and when the authority area is not included.
The specific decision will deal with the adult’s:
- healthcare:
- procedures
- examinations
- treatments
- temporary placement to, or discharge from, a residential facility, including:
- nursing homes
- rehabilitation centres
- approved hospitals
- auxiliary care
- licensed group homes
Specific decision-making does not apply to:
- psychosurgery
- sterilization – unless it is part of a life saving measure
- tissue transplant – unless it is part of a life saving measure
- experimental activities
- end of life decisions
How specific decision-making works
Step 1. Assess the adult
A health-care provider, such as a doctor, nurse practitioner or dentist, completes a capacity assessment to determine if the adult is incapable of making a health care or residential living decision.
Step 2. Select a specific decision-maker
A health-care provider selects a decision-maker who meets both sets of criteria below.
General criteria
A specific decision-maker must:
- be 18 years old or older
- be available and willing to make the decision
- have had contact with the adult within the past 12 months
- have no disputes with the adult
- have knowledge of the adult’s wishes, beliefs and values
Ranked-list criteria
In addition to the general criteria, a specific-decision maker must also be a relative of the adult from this ranked list:
- spouse
- partner in an adult interdependent relationship, which means:
- interdependence with another adult for 3 years
- less than 3 years if you have signed an Adult Interdependent Partnership Agreement
- less than 3 years if you have had a biological child together
- adult son or daughter
- father or mother
- adult brother or sister
- grandfather or grandmother
- adult grandson or granddaughter
- adult uncle or aunt
- adult niece or nephew
A health-care provider can ask the Office of the Public Guardian and Trustee (OPGT) to be the decision-maker if:
- there is no person available that meets the criteria
- there is a conflict among relatives as to who can make the decision
Download the form: Referral for the Public Guardian to Act as Specific Decision Maker for an Adult.
Step 3. Make a decision
The specific decision-maker makes a decision that must:
- reflect the adult’s wishes, values and beliefs
- consider the benefits and risks of treating the adult, including:
- quality of life
- overall health
- living situation
- respects the individual’s rights and freedoms
Step 4. Fill out the form
A health-care provider describes the decision in this form:
Form 6: Specific Decision-making
The specific decision-maker completes and signs Form 6, which makes the decision official.
Fillable PDF forms may not open properly on some mobile devices and web browsers. See the step-by-step guide or contact PDF form technical support.
After the decision
The specific decision-maker must try to contact the adult’s next closest relative to inform them of the decision.
If the adult has no other relative, the specific decision-maker must notify the OPGT about the decision.
Disagreeing with the decision
A health-care provider can act on the decision if a person who disagrees with the decision does not take action within 7 days.
Disagree with the completed capacity assessment
If someone – the adult or a person who has a close relationship with them – believes the adult can make their own decision, they have 7 days to do one of these things:
- request a new capacity assessment through a Capacity Assessment Report – Form 10
- apply to the court to have the first capacity assessment reviewed
Disagree with the decision that has been made
If someone – the adult or a person who has a close relationship with them – disagrees with the decision, they have 7 days to:
- apply to the court to have the decision reviewed
The health-care provider must be notified that a review is being requested. The decision cannot be acted on until the adult’s capacity or the decision has been reviewed.
Legal advice
Consult a lawyer for legal advice if you want the court to review the decision.