Overview

If an adult has lost the ability to consent to medical treatment or where they live, a healthcare provider can choose one of the adult’s relatives to make a one-time, time-sensitive decision.

This specific decision will deal only with the adult’s:

  • healthcare:
    • procedures
    • examinations
    • treatments
  • temporary placement or discharge from a healthcare facility, which include:
    • nursing homes
    • rehabilitation centres
    • approved hospitals
    • auxiliary hospitals

Specific decision-making doesn’t apply to:

  • psychosurgery
  • sterilization
  • tissue transplant
  • experimental activities
  • end of life decisions

Other authorities

Even if the adult has a guardian or personal directive, the guardian or agent may not have the authority to make decisions about the adult’s healthcare or temporary placement.

Future decisions

For future decisions about healthcare and healthcare facilities, the adult may require a guardian or co-decision-maker.

If the adult regains their ability to make decisions while living in a healthcare facility, they should write a personal directive.

Who can be a specific decision-maker

A specific decision-maker must:

  • be a relative of the adult who has lost their ability to make decisions
  • be over 18 years old
  • 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

If there’s no family member that can be a specific decision-maker, the Office of the Public Guardian and Trustee (OPGT) can be asked to make the decision.

How specific decision-making works

Step 1. Assess the adult

A healthcare provider, such as a doctor, nurse practitioner or dentist, does a capacity assessment to determine if the adult is capable of making decisions.

Step 2. Select a specific decision-maker

A healthcare provider selects a relative of the adult from the following ranked list:

  • spouse
  • partner in an adult interdependent relationship, which means:
    • interdependence with another adult for 3 years
    • less than 3 years if you’ve 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

Step 3. Make a decision

The specific decision-maker makes a one-time decision that must:

  • reflect the adult’s:
    • wishes, values and beliefs
    • quality of life
    • overall health
    • living situation
  • consider the benefits and risks of treating the adult

The OPGT can make the decision if:

  • a willing relative isn’t available
  • there’s a conflict among relatives who can make the decision

Step 4. Fill out the form

A healthcare provider describes the decision in this form:

Specific Decision Making Schedule (Form 6) (PDF, 30 KB)

The specific decision-maker signs the above form, which makes the decision official.

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.

Disagreements over the decision

Anyone who’s not the specific decision-maker can tell the healthcare provider about their concerns for the adult if they:

  • believe the adult can make their own decisions
  • disagree with the decision that’s been made

When someone has these concerns, they must:

  • tell the healthcare provider
  • take one of the these actions within 7 days:
    • ask for a full capacity assessment
    • ask the court to review the previous or new capacity assessment, or
    • ask the court to review the decision

If the person who raised the concerns doesn’t take either of the above actions, the healthcare provider can act on the decision.

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