Advance Directive BC
Table of Contents
What is an Advance Directive in BC?
In BC, an advance directive can be used to decide what healthcare you want to have, or not have, at a later time when you are no longer capable of giving instructions.
You may give or refuse consent to any health care in the future. However, if those instructions are contrary to the law in British Columbia, they will not be carried out and will be severed from the advance directive.
Most advance directives are used to address end-of-life decisions, but can also be used to address specific types of treatments. For example, if you do not want to have a particular kind of treatment or medication, you can specify your instructions regarding those treatments and medication in an advance directive.
In most situations, healthcare providers have to comply with your express instructions in the advance directive.
Who can make an Advance Directive in BC?
Any adult (19 years or older) with capacity may make an advance directive in BC.
Capacity means that you must be capable of understanding the nature and consequences of the advance directive, including the scope and effect of the healthcare instructions and the fact that the healthcare provider may treat you without choosing a temporary substitute decision-maker who might consider other surrounding circumstances at that time.
Healthcare Instructions that are not allowed in an Advance Directive
An instruction to do anything that is prohibited by law or to omit to do anything that is required by law is not valid and must be severed from the advance directive.
Additionally, you cannot consent in an advance to the following types of healthcare:
- abortion, unless recommended in writing by your treating physician and at least one other medical practitioner who has examined you;
- electroconvulsive therapy, unless recommended in writing by your treating physician and at least one other medical practitioner who has examined you;
- psychosurgery (defined as destroying, removing or interrupting the continuity of normal brain tissue, or inserting indwelling electrodes in the brain to alter behaviour or treat psychiatric illness);
- removal of tissue from your living human body for implantation in another human body or for medical education or research;
- experimental health care involving a foreseeable risk that is not outweighed by the expected therapeutic benefit;
- participation in a healthcare or medical research program that has not been approved by a specific ethics committee; or
- any treatment, procedure, or therapy that involves using aversive stimuli to induce a behaviour change.
Who should make an Advanced Directive?
Normally, an advance directive is appropriate if you have:
- a specific diagnosis;
- you are at the end-of-life; or
- you are genetically predisposed to a particular condition and you want to make healthcare decisions related to that condition before you lose capacity.
What is a Living Will?
A living will is typically used to describe any kind of advance care planning document.
While the term “living will” is commonly used by the general population in BC, it is actually a term from the United States. The term “living will” is not present in BC law.
Instead in British Columbia, the most common documents created for advance healthcare planning are a representation agreement and/or an advance directive, and an enduring power of attorney for advance financial planning.