Adults and Consent to Medical Care (Script 428): Difference between revisions
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Adults and Consent to Medical Care (Script 428) (view source)
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'''Who cannot be a witness'''—the following people cannot be a witness: | '''Who cannot be a witness'''—the following people cannot be a witness: | ||
# a person who provides personal care, health care or financial services to the adult for compensation, other than a lawyer or notary. | |||
# a spouse, child, parent, employee or agent of a person described in paragraph (1). | |||
# a person who is not an adult. | |||
# a person who does not understand the type of communication used by the adult. | |||
'''Signing for an adult who is not physically capable'''—if an adult is not physically capable of signing an advance directive, another person can sign it for them if the adult is physically present and directs the person to sign the directive. Their signature must be witnessed as if the adult were signing the directive. The following people must not sign an advance directive for an adult: | '''Signing for an adult who is not physically capable'''—if an adult is not physically capable of signing an advance directive, another person can sign it for them if the adult is physically present and directs the person to sign the directive. Their signature must be witnessed as if the adult were signing the directive. The following people must not sign an advance directive for an adult: | ||
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*if, after the advance directive was made, significant changes in medical knowledge, practice, or technology have been made that might substantially benefit the adult in relation to health care. | *if, after the advance directive was made, significant changes in medical knowledge, practice, or technology have been made that might substantially benefit the adult in relation to health care. | ||
'''Substitute decision-makers'''—in some cases, another person can make medical decisions for you if you’re too ill or unable. If you’ve made a representation agreement allowing your representative to make all major and minor health decisions for you, your representative can make the medical decision. Script [[Power of Attorney and Representation Agreements (Script 180)|180]], called “Power of Attorney and Representation Agreements” has more on this. If you’re mentally incapable, a person appointed by the court as a committee (pronounced comm-it-tay) of the person can make medical decisions for you – check script [[Committeeship (Script 426)|426]], called “Committeeship”. | |||
But if you have no representative or committee of the person, your health care provider must choose a '''temporary substitute decision-maker''', or '''TSDM''', based on what the Act requires, as the next section explains. | But if you have no representative or committee of the person, your health care provider must choose a '''temporary substitute decision-maker''', or '''TSDM''', based on what the Act requires, as the next section explains. | ||
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#a person immediately related by marriage | #a person immediately related by marriage | ||
The TSDM must be at least 19 years old, | The TSDM must be at least 19 years old, be capable, and have no dispute with you. They must also have been in contact with you in the past 12 months. | ||
==What kind of decisions can the temporary substitute decision-maker (TSDM) make?== | ==What kind of decisions can the temporary substitute decision-maker (TSDM) make?== | ||
The TSDM | The TSDM can make decisions about any kind of health care, except controversial or irreversible treatments such as organ transplants and experimental surgery. [http://www.bclaws.ca/civix/document/id/complete/statreg/20_2000#section5 Section 5] of the [http://www.bclaws.ca/civix/document/id/complete/statreg/20_2000 Health Care Consent Regulation] says a TSDM cannot consent to those types of health care. | ||
[http://www.bclaws.ca/civix/document/id/complete/statreg/96181_01#section18 Section 18(2) of the Act] allows the TSDM to say no to life-saving treatment if you’re terminally ill or critically injured and your doctor will follow their decision. But the doctor may challenge the TSDM if their decision is medically inappropriate and there’s no evidence that their decision reflects your wishes and is in your best interests. | |||
==What are the duties of a TSDM?== | |||
The TSDM must consult with you if possible. If that’s not possible, the TSDM must comply with any directions you gave while you were capable. You should let your family know now what decisions you would like if you can no longer decide for yourself. If you wishes are unknown, the TSDM must give or refuse consent in your best interests, considering whether: | |||
* your condition will improve with the proposed health care. | |||
* the condition will improve without the health care. | |||
* the benefit of the health care is greater than the risk of harm. | |||
* less restrictive or less intrusive health care would be as helpful as the proposed health care. | |||
==What if someone disagrees with a health-care decision of the TSDM?== | ==What if someone disagrees with a health-care decision of the TSDM?== | ||
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==Applying to court== | ==Applying to court== | ||
Under Section 33(4) of the Act, the following people can apply to court for an order on certain things: | Under [http://www.bclaws.ca/civix/document/id/complete/statreg/96181_01#section33.4 Section 33(4) of the Act], the following people can apply to court for an order on certain things: | ||
*a health care provider caring for an adult incapable of giving or refusing consent to health care. | *a health care provider caring for an adult incapable of giving or refusing consent to health care. | ||
*an adult's representative or personal guardian. | *an adult's representative or personal guardian. | ||
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==More information== | ==More information== | ||
To learn more about consenting to – and refusing – medical care, call the Public Guardian and Trustee of BC at 604.775.1007 in Vancouver, 604.775.1001 in the lower mainland, and 1.877.511.4111 elsewhere in BC (the call is free). Also, check the | To learn more about consenting to – and refusing – medical care, call the Public Guardian and Trustee of BC at 604.775.1007 in Vancouver, 604.775.1001 in the lower mainland, and 1.877.511.4111 elsewhere in BC (the call is free). Also, check the [http://www.trustee.bc.ca/ Public Guardian and Trustee website] and the [http://www.gov.bc.ca/health Ministry of Health website]. | ||
[updated February | [updated February 2016] | ||