Advance Care Planning and Representation Agreements


In the lead up to National Advance Care Planning Day, which took place on April 16th, the Globe and Mail printed a short interview with Balfour Mount, the creator of the term “palliative care”. His work focuses on relieving patients’ pain and preventing patients’ suffering by taking a holistic approach to patient care. Palliative care recognizes that pain and suffering is not only physical, but also mental, emotional, spiritual, and social. It deals with all of these aspects. You might ask: what does this have to do with estate planning?

Advance care planning has informal and formal components. Informally, a person should discuss his or her wishes with family members, including wishes with respect to palliative care. Formally, a person should engage a legal professional to discuss and prepare certain legal documents.

The Representation Agreement Act permits a person to choose a representative who will make decisions about his or her health care and personal care, among other things, if that person becomes incapable of making decisions independently. This is related to palliative care in at least two ways. Firstly, if a legally-competent palliative-care patient has a care plan in place that includes a representation agreement, an element of stress is removed from an already-difficult situation. Secondly, if a palliative-care patient becomes unable to make his or her own decisions, it is comforting to know that a representative of the patient’s choosing (and presumably a person with whom the patient has discussed this responsibility) is making decisions in the patient’s stead, including palliative-care decisions.

Let National Advance Care Planning Day serve as a reminder to ask the difficult questions: What will happen if I am incapable of making my own decisions? What will happen if my loved ones are unable to make their own decisions? These are not easy questions but they are nevertheless questions that should be asked.

Thanks for reading.