Under the Care Consent Act you've the right to refuse care on any grounds. Your permission is needed for all care decisions, except for:
- emergency health care (if the care provider knows your wishes they must follow them);
- a preliminary examination; and
- health care already in progress.
If you are not able to consent
A health care provider will find another person to make decisions for you if:
- it is not an emergency; and
- you are not able to make your own health care decisions (for example, you're unconscious).
Who can make decisions for you?
The person must be over 19 years of age. The care provider will start at the top of this list and work their way down until they find someone to give consent:
- guardian appointed by the Supreme Court for an adult, or guardian of a child;
- proxy appointed by the person through an advance directive;
- spouse, including common-law and same-sex partners who've lived together for the previous 12 months;
- brother or sister;
- any other relative; and
- close friend.
If no person can be found, 2 to 3 care providers will make decisions for you.
Why be a substitute decision-maker?
Being a substitute decision-maker is a very important role. It can be very stressful – sometimes family members do not agree on the decision that should be made. It's important to focus on the needs of the person who needs the decision made on their behalf. Family and friends are in the best position to make these decisions on behalf of the people they love.
What decisions can a substitute decision-maker make?
If you're a substitute decision-maker you may be asked to make decisions about:
- health care (for example, medical treatment, dental care, diagnostic procedures);
- admission to a care facility (for example, nursing home, group home for adults with cognitive disabilities); or
- personal assistance services (for example, home care, personal care in a care facility).
What are the duties of a substitute decision-maker?
As a substitute decision-maker you must:
- consult with the person to the extent reasonable, given their condition;
- consult with any friend or relative who asks to assist if the you do not know the person’s values or wishes;
- follow the wishes expressed by the person when they were still capable and after they turned 16 years of age unless:
- it's impossible to follow the wish; or
- you believe that because of changes in knowledge, technology or practice, the person would no longer act on the wish;
- use the person’s wish as guidance where it does not clearly anticipate the specific circumstances that exist;
- make a decision based on the person’s values and beliefs if you do not know the person’s wishes;
- make a decision based on what's in the person’s best interests if you do not know the person’s values and beliefs or wishes;
What to think about when making a decision
If you're making a decision based on what's in the person’s best interests, consider:
- the person’s current wishes;
- whether the person’s condition or wellbeing is likely to improve, worsen or stay the same if the person receives the care;
- whether the person’s condition or well-being is likely to improve, worsen or stay the same if the person does not receive the care;
- whether the benefits of the care will outweigh the risks or negative consequences;
- whether a less restrictive or less intrusive form of available care would have greater benefits or less negative consequences; and
- only attempt to get information that's required to make the care decision; and
- keep all personal information confidential and secure.
Can a decision be challenged?
Someone may ask the Capability and Consent Board to review your decision if they believe you have not carried out your duties in making a care decision. The board may give the you some direction, or they may ask that another substitute decision-maker be chosen.
48-hour waiting period before treatment
If you consent to major health care on behalf of a person, the treatment may not be provided for 48 hours. The only exception is if the person’s health will deteriorate. This allows time for someone to apply to the Capability and Consent Board for a review of the matter if they disagree with your decision.
In an emergency
If a health care provider believes that the your are not following your duties, the health care provider can disregard your decision in an emergency.
Download our brochure about the role of a substitute decision-maker.
Forms for substitute decision-makers
You can be a substitute decision-maker for a friend.
- Complete this form.
- Keep a copy for yourself.
- Give the original to your friend. They need to keep it with their health record.
As a care provider, you can make substitute decisions for a person who receives your care.
- Complete this form.
- Submit the form to the Capability and Consent Board.
Ask for a review of a care decision
You can ask for a review of a major health care decision made for someone else.
Who can ask for a review?
- The person receiving the care
- A care provider or health care provider
- A substitute decision-maker
- Another person with substantial interest
How to apply
- Complete this form.
- Submit the completed form to the Capability and Consent Board.