Seniors experiencing a loss of autonomy
Advance medical directives to prepare for your health care in case of incapacity
Advance medical directives allow you to decide beforehand if you wish to receive or refuse certain health care if you’re no longer able to communicate your choices. Here’s what you need to know about this process.
Refusing or accepting care now for future situations
Advance medical directives are recorded in a document and allow you to indicate beforehand whether or not you wish to receive certain health care.
When you're no longer able to express your wishes regarding the medical care you’d like to receive, medical personnel may then consult your advance medical directives to determine the care to give you.
Directives used in certain situations only
The advance medical directives you’ve prepared will serve only as a reference document for health professionals if the following two conditions are met:
- You're no longer capable of giving consent to care
- You’re in one of the following three situations specified by the law:
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- You suffer from a serious and incurable medical condition and are at the end of life.
- You're in a coma deemed irreversible or in a permanent vegetative state.
- You have serious dementia with no possibility of improvement. In the medical community this is also referred to as “major neurocognitive disorders” (e.g., Alzheimer’s disease).
Did you know?
The inability to take care of yourself must not be confused with the inability to consent to care. An individual may be considered incapable of managing his or her property and finances, but capable of making decisions concerning his or her health care.
Therefore, individuals represented by a mandatary or a tutor may be capable of consenting to their own care. It’s important to look at each situation on a case-by-case basis.
Only five treatments can be decided in advance
You can use advance medical directives to express your wishes concerning the following five treatments:
- Cardiopulmonary resuscitation
- Ventilator-assisted breathing or breathing assisted by another technical support
- Dialysis
- Forced or artificial feeding
- Forced or artificial hydration
Therefore, you cannot use advance medical directives to express your wishes concerning medical aid in dying.
Have you expressed your wishes concerning these five treatments in other documents?
You may have expressed your wishes concerning these five treatments in other documents than your advance medical directives, for example, in your protection mandate (previously called a “mandate in case of incapacity”).
If this is the case, it’s important to note that advance medical directives take precedence. Therefore, medical staff will follow these directives even if your protection mandate is more recent.
Your advance medical directives will also take precedence over the opinion of the persons close to you, your mandatary, or your tutor.
What if you change your mind?
If you wish to modify the choices in your advance medical directives, you can draft new ones as long as you’re capable of giving consent to care.
If you wish to cancel your advance medical directives, you can follow the revocation procedure with the RAMQ.
Also, if you become incapable of giving consent to care but categorically refuse to receive a treatment that you consented to in your advance medical directives, the medical staff will not be permitted to provide you with the care you refuse without a court order.
To learn more about how to modify or cancel your advance medical directives, please consult our “How to prepare advance medical directives” page.
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ANG - L’information présente sur cette page ne constitue pas un avis ou un conseil juridique. Nous vous indiquons ce que dit la loi au Québec de manière générale. Pour obtenir un avis ou un conseil juridique concernant votre situation personnelle, consultez un professionnel du droit.