Advance Directive

Advance Directive 

An Advance Directive is a legal document in British Columbia when made according to the requirements set out in the Health Care Consent and Care Facility Admission Act. These requirements came into effect on September 1, 2011.

An Advance Directive (AD) is a written instruction to give or refuse consent to certain health care matters. It must be made when the adult is capable of understanding the nature and effect of what it covers. Click to read the AD fact sheet.

A stand-alone Advance Directive – written for a health care provider to follow on its own – has limited use. As many health care providers will tell you: “It is impossible to predict the future, especially for a health care condition because people react very differently.”   

  • The instruction must describe the specific type of health care (e.g. blood transfusion). An Advance Directive can NOT cover personal care matters.
  • The instruction must apply to the health care situation or circumstance at the time consent is needed (when the patient is determined incapable of informed consent).
  • The instruction must be clear enough that a health care provider can confidently act on it without talking to anyone else. (We refer to this as a ‘stand-alone’ AD).

Two key reasons Advance Directives do not work on their own are:

  1. They are not clear. (Most examples of Advance Directive wording do not meet the standards of the BC legislation. They include qualifications that require interpretation – If I cannot communicate….)
  2. The health care provider does not know the patient or their values. They have no context for the instruction and will not feel confident to follow it.

 
A Representation Agreement is a legal document in BC that covers health care AND personal care matters. It is for authorizing one or more people to assist you with decisions or, if necessary, to act on your behalf.

You can discuss and give any written wishes (e.g. living will) or instructions to your representative and alternate. They apply these to the specific circumstance as YOU intended.

Click to watch Nidus videos on Representation Agreements and planning for health and personal care