Seniors experiencing a loss of autonomy
How to prepare advance medical directives
Advance medical directives allow you to decide beforehand if you wish to receive or refuse certain health care procedures. Some legal formalities have to be followed when preparing them. Here is an overview of the process.
A notary can help
You can ask a notary to help you prepare your advance medical directives. The notary can make sure that your advance medical directives and your protection mandate (if you prepared one) are consistent with each other and complimentary.
1) Do some research before filling out the form
Advance medical directives allow you to decide beforehand if you wish to receive or refuse the following five health care services:
- Cardiopulmonary resuscitation
- Ventilator-assisted breathing or breathing assisted by another technical support
- Dialysis
- Forced or artificial feeding
- Forced or artificial hydration
It’s important to understand the nature of these types of services and the consequences of receiving or refusing them before you make your decision. Ask your doctor for more information about them.
2) Be sure you meet the conditions
To prepare advance medical directives, you must be of full age and capable of giving consent to health care.
In concrete terms, this means that when you prepare your advance medical directives, you must be able to understand the information in the form, in particular the information about:
- the proposed treatment
- the advantages and drawbacks of using these treatments
It also means that you’re able to make decisions and express them.
Did you know?
The capacity to consent to care must not be confused with the capacity to take care of oneself.
An individual can 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 giving consent to their own care and therefore of issuing advance medical directives.
It’s important to look at each situation on a case-by-case basis.
3) Obtain the form from the Régie de l’assurance maladie du Québec (RAMQ)
To prepare advance medical directives, it’s mandatory to use the model form provided by the RAMQ.
To obtain it, contact RAMQ by telephone at 1 800 561‑9749 or download and print the form entitled “Advance Medical Directives in Case of Incapacity to Consent to Care” available through your clicSÉQUR account.
4) Complete the form and sign it before two witnesses
You must sign the form before two witnesses, both of full age and capable. Medical staff members can be witnesses, for example.
The form comprises three sections. The first section provides general information. The second is where you indicate your choices for the five types of care in the three defined medical situations.
Make sure you initial each page. The third section is where you sign and date the form in the space provided.
5) Inform medical staff that you have advance medical directives
To ensure that your choices regarding your care are respected, the medical staff must be informed that you have advance medical directives.
There are different ways to make sure they know. You can:
- Send your directives directly to the RAMQ, who will file them in the advance medical directives register.
- Give your directives to a health professional, who will file them in your medical record.
- Give your directives to a person you trust, who can send them to a health professional if you become incapable.
If you hire a notary to prepare your advance medical directives, you can ask for them to be forwarded to the Régie de l’asssurance maladie du Québec (RAMQ) so that they can be filed in the advance medical directives register.
6) You can change your mind
You can modify your choices in your advance medical directives as long as you’re capable of consenting to health care.
To do so, you simply need to write new ones, following the same formalities as the first time. Your new directives will replace your former ones. Don’t forget to send them to the RAMQ so that they can replace the ones in the register.
You can cancel your advance medical directives.
To do so, you must:
1. Call the RAMQ to request a revocation form.
2. Complete the revocation form.
3. If your advance medical directives are in your medical record or the RAMQ’s register, you have to send the revocation form to a medical professional or the RAMQ.
4. Destroy all copies of your advance medical directives, for example, those you’ve saved at home. They remain valid even if they’re no longer in the advance medical directives register.
Don’t forget to inform anyone close to you who knows about your advance medical directives. Also don’t forget to tell your notary if you used one to prepare the directives.
Medical staff cannot provide you with care that you categorically refuse, even if you’re considered incapable of giving consent to care and you’ve consented to this care in your advance medical directives.
However, in this situation, a court may order that you receive this care.
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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.