Nunatsiaq News
COMMENTARY: Nunavut November 01, 2017 - 3:30 pm

Legal Ease, Nov. 1

What if I am too sick to tell the doctor what to do?


The recent serious illness of a relative made me think of what happens when someone gets sick and cannot make decisions for themselves.

As a practical matter, health centres and the hospital in Iqaluit look to the close family of an ill person to give direction in circumstances where that person cannot speak for themselves. So they must listen to the spouse or children.

And usually that is enough. The sick person’s family loves them and most often agree with what needs to be done.

So someone is badly injured—should they be medevaced south? Someone has a blood infection but they react badly to antibiotics—should they be treated even if the chances of recovery are very slim? If the sick person cannot speak for themselves but the family all agree on what is to be done, that is normally what happens. 

But sometimes the family does not agree. What if the children want aggressive treatment and the spouse prefers just palliative care?

It used to be that in those circumstances the spouse was usually given the decision-making power, but that’s not always the case now, especially for second spouses where there are adult children.

It is possible to get a court order that appoints someone to make the decisions for an otherwise incompetent person. That said, going to court is expensive and often a decision needs to be made right away and even if the court acts very quickly, nothing happens immediately.

At a minimum, you need a day or so to get a decision from the court—and if you are not able to get a lawyer right away, and you live in a smaller community, it may take several days to line everything up. Medical treatment, usually, cannot wait days or even hours.

So what can you do to make sure someone can speak for you should you be unable to speak for yourself? 

In many parts of Canada there is legislation that expressly allows you to appoint someone to be your decision-maker should you become incapacitated. Unfortunately we do not have such legislation in Nunavut yet.

Nevertheless, if you write a note saying that you want, for example, your spouse to make decisions for you when you are unable to make those decisions, the note will be given a lot of weight.

The note should be very clear: “If I am too ill to make decisions for myself I want decisions about my care to be made by…” whomever—and you should date and sign the note, preferably with two witnesses.

Again, the note is not absolutely binding, but it does show your considered wishes and will be given a lot of weight.

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