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Making a Directive

A health care directive is made in advance to plan for a time when you may not be able to make or communicate your health care choices.

What is a Health Care Directive?

A health care directive is a document you create to express you wishes about your health care when you are not able to do so. You are not able to express your health care wishes when you cannot:

  • understand information relevant to the health care decision
  • appreciate the reasonably foreseeable consequences of making or not making the health care decision
  • communicate the health care decision

When to Make a Directive

You must make a health care directive while you are still of sound mind. It is important to make one before your health deteriorates. You can make a health care directive if you are:

  • at least 16 years of age
  • able to understand information about potential treatments and their consequences
  • able to communicate your decisions

A health care directive will only take effect if you cannot directly consent to or refuse treatment. Health care providers are protected from legal action if they follow your directive.

You may want to make a directive in a situation where you know you are ill. For example:

  • if you are facing a terminal illness
  • if you have an illness where you may have periods when you are incapable of making or communicating health care decisions

You may also choose to make a directive when you are in good health. If something unexpected happens, your directive will allow you to communicate your health care wishes.

Before making a directive, you may want to discuss treatment options and other issues with your doctor or other health care providers. You will also want to have discussions with family members and your proxy if you name one.

Some Formalities

A Power of Attorney cannot be used to make health care decisions. Only a health care directive can deal with these matters.

The law requires that a health care directive be in writing - either handwritten or typed. It must include your signature and the date. If you sign the directive yourself, it does not need to be witnessed.

If you are unable to sign the directive yourself, someone else may sign for you at your direction and in your presence. Another person must be a witness to this signature. The person signing and the witness cannot be your proxy or your proxy’s spouse.

A directive does not need to be made in Saskatchewan to be effective. As long as it meets the requirements under Saskatchewan law, it will be valid in Saskatchewan. If you live somewhere else, there may be different requirements so you should check the applicable laws there.

A lawyer can prepare a health care directive for you for a fee. You may also choose to make a health care directive without the assistance of a lawyer. There is no particular form that you must use. Some agencies offer templates for directives that you can use as a guide. It is important to remember, however, that you should tailor a directive to your own situation.

What to Include in a Directive

A directive cannot permit medical assistance in dying (MAID).

Your directive can give specific directions regarding certain treatments and situations. A health care directive can cover matters like:

  • diagnostic testing
  • blood transfusions
  • resuscitation
  • life support
  • feeding tubes
  • antibiotics
  • surgical procedures
  • palliative or comfort measures

For example, it may specify that you do not want to be kept alive by a ventilator or feeding tube if you are in a persistent vegetative state. It could also specify that you do not wish to be resuscitated or that you want comfort measures only. You should be as clear and specific as possible. Health care providers do not have to follow directives that are not clear.

If your directive does not cover a situation that arises and does not name a proxy, health care providers will use it only as a guide when deciding on treatment.

Looking for sample forms?

The Saskatchewan Health Authority provides a sample form in their My Voice Workbook.

The Funeral Advisory and Memorial Society of Saskatchewan also links to a few sample forms.

Proxies

You may not want or be able to plan for every possible situation. In this case, you can name someone to act for you when you cannot speak for yourself. This person is called a proxy and can make health care decisions for you as required. You appoint a proxy by naming them in your health care directive.

You can choose to have your proxy make all or some health care decisions for you when you cannot. Your proxy will only make decisions for you when your directive does not address the situation.

If you name your spouse as proxy and later divorce, the appointment will be revoked unless your directive states that the appointment will continue if you divorce.

Your proxy does not need to be a family member. You can choose any person who is at least 18 years old and has the capacity to make health care decisions. A married person who is not yet 18 may be a proxy for their spouse.

You may name two or more proxies if you wish. They may be named as alternate or joint proxies. Joint proxies make decisions by majority vote. If they cannot, then the proxy listed first in the directive decides. An alternate proxy can make decisions if the primary proxy cannot.

You should choose someone you trust as your proxy. Treatment wishes should be discussed clearly and completely with your proxy. If your proxy knows your wishes, they must act according to your wishes. If your proxy does not know your wishes, your proxy must act according to what they believe is in your best interests.

Your proxy cannot pass this responsibility on to another person. If, however, they are unable or unwilling to act and your health care directive does not deal with the matter, your next-of-kin may speak on your behalf.

Personal Guardians

If you have made a health care directive and the court later appoints a personal guardian, they will follow your directive to determine health care issues. If your directive does not give instructions for a particular situation, and a proxy was named in your directive, your proxy's decision will be preferred. If there is a disagreement, either the proxy or the personal guardian may apply to the Court of King's Bench for direction.

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