Advanced Directives

The world is full of things that are taboo to talk about. There’s an age-old adage that says you should never talk about religion, politics or money at the dinner table; the reasoning is that these topics are pretty controversial, and the mood of the dinner could go sour. You might throw another couple of items onto the list: you shouldn’t talk about sports if you’re cheering for different teams (or surrounded by people who couldn’t care less), and it goes without saying that we don’t talk about death when sitting down for a meal. In fact, we rarely broach the subject of death at all in polite conversation - but what if we did? In a podcast by Planet Money (an NPR show in the United States), they discussed “The Town That Talks About Death”. A lot of the legal elements of what was discussed in that podcast won’t be relevant to Canadians, but the sentiment of it is extremely relevant. What they discuss is advanced directives.

An advanced directive is, in the simplest terms, a document that tells people how to handle your healthcare should you become incapacitated, and no longer able to make decisions. There’s a couple of different advanced directives we’ll discuss here: the living will, and medical power of attorneys.

Living wills are specific directives set by you in the case that you are incapacitated. They will instruct healthcare providers on important issues, like whether or not you want to stay on a breathing machine (and for how long), whether or not you want to continue with treatments like chemotherapy, whether or not you wanted to be resuscitated through CPR (DNR), and other important instructions about how you want your care to proceed. They are called living wills because they are orders the medical team and your family must follow even if you’re still alive - this is possible because the decisions pertain to your healthcare, and decisions about your healthcare are your right.

Another form of advanced directive you can employ is a medical power of attorney (power of attorney for personal care), sometimes called a proxy. People will often have two powers of attorney, one who acts for decisions regarding property and finance, and the proxy. When it comes to choosing a proxy, you should choose someone who you trust to make healthcare decision for you when you are incapacitated; it is not considered the good practice to use someone who is paid to care for you as a proxy. In Manitoba, you can declare more than one proxy, should you choose to.

There are a few resources you should be aware of when pursuing an Advanced Directive. In Manitoba, Advanced Directives are known as Health Care Directives; you can find more information here. For those interested in knowing more about the legal elements of advanced directives in Manitoba, read the Health Care Directives Act.

It’s important to talk to your friends, family, and healthcare team about any advanced directives you have in place. That’s because it is not necessary for healthcare professionals to ask about health care directives before pursuing care in Manitoba, but they must act on those directives if they are known (and fall in line with accepted health care practices). That means that letting your loved ones know about your advanced directives isn’t just important for your relationship, it’s important to ensure your wishes are upheld. When it comes to the interaction between a living will and a medical power of attorney, in Manitoba it’s stipulated that your proxy must follow the written wishes in your Health Care Directive, unless they are certain that your wishes had changed but not yet been written down. There are also a number of clauses that prevent abuse of your directive by proxies; that said, you should still pick a proxy who you trust immensely.

At Alterna Cremation, we offer cremation services for Winnipeg and the surrounding area. We will continue to publish articles so you can learn about end-of-life planning, to give you and your loved one's peace of mind. Continue to read our blog, and check out our resources for more information; if you have any questions or concerns, never hesitate to contact us.