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 do not open properly on some mobile devices and web browsers.
If you are having problems opening the form, 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.