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Difference between revisions of "Advance Directives (15:VI)"
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Advance Directives (15:VI) (view source)
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In the absence of an AD, if the adult has not appointed a Representative, then the health care provider will seek consent from a Temporary Substitute Decision-Maker (TSDM), as set out in s 16 of the HCCFA. | In the absence of an AD, if the adult has not appointed a Representative, then the health care provider will seek consent from a Temporary Substitute Decision-Maker (TSDM), as set out in s 16 of the HCCFA. | ||
== B. Making an Advance Directive == | == B. Note on Medical Assistance in Dying == | ||
The Criminal Code of Canada was amended on June 17th, 2016, to permit the Medical Assistance in Dying (MAiD) under certain conditions. This means that a medical or nurse practitioner may, at the person’s request, administer a substance to cause their death, or prescribe a substance so that the person can self-administer a substance that causes their death. | |||
Consent given through substitute decision makers, such as Representatives under the RA Act, and Advanced Directives are '''NOT''' sufficient for medical practitioners to provide MAiD. MAiD can only be provided to patients who are able to give consent as of July 15th, 2016. | |||
This is because the College of Physicians and Surgeons of British Columbia’s “Professional | |||
Standards and Guidelines” regarding MAiD clearly prohibit consent given through Ads and RAs. The Professional Standards and Guidelines have weight in law pursuant to section 5(2) of the Medical Practitioners Regulation under the Health Professions Act. | |||
For more information on the Standards and Guidelines of the College of Physicians, please see their document on MAiD at: https://www.cpsbc.ca/files/pdf/PSG-Medical-Assistance-in-Dying.pdf | |||
== C. Making an Advance Directive == | |||
An AD must include or address any prescribed matter and indicate that the adult knows the following: | An AD must include or address any prescribed matter and indicate that the adult knows the following: | ||
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For more information, refer to [[Introduction to Adult Guardianship (15:II)#2. Health Care Consent | section II.B.2: Mental Capacity; Health Care Consent]] in this chapter. | For more information, refer to [[Introduction to Adult Guardianship (15:II)#2. Health Care Consent | section II.B.2: Mental Capacity; Health Care Consent]] in this chapter. | ||
== | For more information on preparing documents, consult the Appendix or organizations such as Nidus Personal Planning Resource Centre and Registry. Contacting information may be found in section II. C: Resource Organizations of this chapter. | ||
== D. Changing, Revoking or Ending an Advance Directive == | |||
An adult with capacity is able to revoke or change an AD at any time. According to s 19.6 of the HCCFA, an adult who has made an AD may change or revoke the AD as long as the adult is capable of understanding the nature and consequences of the change or revocation. | An adult with capacity is able to revoke or change an AD at any time. According to s 19.6 of the HCCFA, an adult who has made an AD may change or revoke the AD as long as the adult is capable of understanding the nature and consequences of the change or revocation. | ||
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A revocation may be made by expressing an intention to revoke an AD and then making another document, including a subsequent AD. Alternatively, an AD may be revoked by destroying the AD with the intention to revoke it. | A revocation may be made by expressing an intention to revoke an AD and then making another document, including a subsequent AD. Alternatively, an AD may be revoked by destroying the AD with the intention to revoke it. | ||
== | == E. Examples of Advance Directive Provisions == | ||
Examples of directives made in an AD might include consenting or refusing consent to the following: | Examples of directives made in an AD might include consenting or refusing consent to the following: | ||
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*blood cultures, spinal fluid evaluations, and other diagnostic tests; and/or | *blood cultures, spinal fluid evaluations, and other diagnostic tests; and/or | ||
*blood transfusions. | *blood transfusions. | ||
Note that it is not likely that simple refusals like "I refuse CPR" are going to be sufficient for health care providers. It is important to describe the circumstances to the best degree possible under which consent will be refused, such as only refusing CPR if cardiac arrest occurs, rather than stating only to refuse CPR. The adult may use the phrase "under any circumstances" to make it clear to health care professionals that consent is not given in any case. | |||
:'''NOTE:''' The adult should have their AD added to their doctor’s patient files, their hospital records, and any other relevant agencies. If the AD is revoked or altered, the adult should advise each of these agencies or provide them with the new or revised AD. | :'''NOTE:''' The adult should have their AD added to their doctor’s patient files, their hospital records, and any other relevant agencies. If the AD is revoked or altered, the adult should advise each of these agencies or provide them with the new or revised AD. | ||