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Difference between revisions of "Types of Substitute Decision-Making in Residential Care"
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Types of Substitute Decision-Making in Residential Care (view source)
Revision as of 17:02, 3 July 2014
, 17:02, 3 July 2014→4. Substitute Decision-Making Through Instructions - Advance Care Directives
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Having a committee appointed has a major effect on existing legal documents it terminates a power of attorney, including an enduring power of attorney. It usually terminates a representation agreement as well. | Having a committee appointed has a major effect on existing legal documents it terminates a power of attorney, including an enduring power of attorney. It usually terminates a representation agreement as well. | ||
== | ==Substitute Decision-Making Through Instructions - Advance Care Directives== | ||
An advance directive is not substitute decision-making. It is a set of instructions to health care providers. However in effect it can make the health care provider the substitute decisionmaker for health care decisions in specific circumstances. | An advance directive is not substitute decision-making. It is a set of instructions to health care providers. However in effect it can make the health care provider the substitute decisionmaker for health care decisions in specific circumstances. | ||
=== | ===The Basics=== | ||
Advance directives are recognized by Part 2.1 of the Health Care Consent and Care Facility (Admission) Act. They must be in writing and witnessed by two people. There are prohibitions on who can be witnesses. The advance directive can be changed or revoked by the person, if the person changes her or his mind at some point in the future. | Advance directives are recognized by Part 2.1 of the Health Care Consent and Care Facility (Admission) Act. They must be in writing and witnessed by two people. There are prohibitions on who can be witnesses. The advance directive can be changed or revoked by the person, if the person changes her or his mind at some point in the future. | ||
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:(a) the scope and effect of the health care instructions set out in the advance directive (basically that a health care provider may not provide to the adult any health care for which the adult refuses consent in the advance directive), and | :(a) the scope and effect of the health care instructions set out in the advance directive (basically that a health care provider may not provide to the adult any health care for which the adult refuses consent in the advance directive), and | ||
:(b) a temporary substitute | :(b) a temporary substitute decision-making will not be chosen to make decisions on the adult’s behalf for any matter that is covered in the advance directive. | ||
The BC Ministry of Health has developed an advance directive form for individuals to use when undertaking advance care planning, but using the form is optional. | The BC Ministry of Health has developed an advance directive form for individuals to use when undertaking advance care planning, but using the form is optional. | ||
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Also if the health care decision falls into one of the exceptions set out in section 19.8., e.g. it is not covered by the advance directive. The advance directive will not be followed if there is a “committee of the person” or representation agreement in effect (unless the representation agreement states that certain decisions are to be as set out in the advance directive and not made by a representative). | Also if the health care decision falls into one of the exceptions set out in section 19.8., e.g. it is not covered by the advance directive. The advance directive will not be followed if there is a “committee of the person” or representation agreement in effect (unless the representation agreement states that certain decisions are to be as set out in the advance directive and not made by a representative). | ||
=== | ===Common Legal Issues with Advance Directives=== | ||
Advance directives can provide consent or refuse consent to health care. Although people have often expressed their wishes formally or informally to family, friends or care providers, advance directives are a relatively new recognized legal document in British Columbia. Advance directives have typically been considered as geared to “end of life care”, and may not be well suited for what happens in providing day to day health care for people living in residential care facilities. | Advance directives can provide consent or refuse consent to health care. Although people have often expressed their wishes formally or informally to family, friends or care providers, advance directives are a relatively new recognized legal document in British Columbia. Advance directives have typically been considered as geared to “end of life care”, and may not be well suited for what happens in providing day to day health care for people living in residential care facilities. | ||
