Representation Agreements
Table of Contents
What is a Representation Agreement in BC?
A representation agreement (sometimes referred to as a medical representation agreement or a health care representation agreement) is an important incapacity planning tool in the province of British Columbia.
In BC, a representation agreement allows you to appoint, in advance, one or more representative(s) who can make healthcare decisions and personal care decisions on your behalf if you are unable to do so due to mental incapacity. In contrast, an enduring power of attorney is the primary tool for personal planning regarding finances, property, and legal affairs.
The British Columbia Representation Agreement Act allows you to draft two kinds of representation agreements. The two representation agreements are commonly referred to as a Section 7 (Standard) Representation Agreement and a Section 9 (Enhanced) Representation Agreement.
Who can make a Representation Agreement in BC?
Any adult over the age of 19 in British Columbia may make a representation agreement.
If the adult has full mental capacity, they can make a section 9 representation agreement.
If the adult does not have the requisite mental capacity to make a section 9 representation agreement, they can only make a section 7 representation agreement.
Section 9 Representation Agreement
In BC, a section 9 representation agreement, also known as an enhanced representation agreement, allows you to appoint a representative who can make general health care and personal care decisions for you, including certain end-of-life decisions.
But, note that under the current law, a representative cannot consent on your behalf to Medical Assistance in Dying (“MAID”).
Who can make a Section 9 Representation Agreement?
A section 9 representation agreement can only be made by an adult who has the capacity to understand the nature and consequences of the agreement.
An adult who has already lost mental capacity cannot make a section 9 representation agreement. In that a case, a section 7 representation may be possible.
What can a Section 9 Representative do?
In a section 9 representation agreement, you can authorize your representative(s) to:
- decide where you can live and with whom, including whether you should live in a care facility;
- decide whether you should work and if so, the type of work and employer;
- decide whether you should participate in activities;
- decide who you should have contact with;
- make day-to-day decisions on your behalf;
- give or refuse consent to personal care;
- give or refuse consent to any major healthcare or minor healthcare
- hire qualified individuals to help them provide you with healthcare or personal care;
- access your medical and hospital records; and
- follow your specific wishes.
Section 7 Representation Agreement
A section 7 representation agreement allows you to appoint a representative who can make decisions on your behalf related to:
- routine financial decisions (except real property, such as real estate);
- personal care decisions;
- healthcare decisions (except end-of-life decisions); and
- legal decisions (instructing a lawyer and settling any legal proceedings).
Who can make a Section 7 Representation Agreement?
In contrast to a section 9 representation agreement, a section 7 representation agreement does not require an adult to have full mental capacity.
Therefore, a section 7 representation agreement is recommended when an adult does not have the full capacity required to make a section 9 representation agreement.
What can a Section 7 Representative do?
a) Routine Financial Decisions
In a section 7 representation agreement, you can authorize your representative(s) to manage your routine financial affairs, including but not limited to:
- pay your bills;
- receive your pension and income;
- open accounts at financial institutions in your name;
- renew or refinance your loans, including a mortgage;
- purchase, renew, or cancel household, motor vehicle, or other insurance, except life insurance;
- sell your personal or household effects, including a motor vehicle, except real estate;
- buy goods and services that are consistent with your means and lifestyle;
- establish an RRSP for you;
- make donations;
- complete and submit your income tax returns; and
- take steps to protect your documents and property.
b) Personal Care Decisions
In a section 7 representation agreement, you can authorize your representative(s) to make the following personal care decisions on your behalf:
- where you can live;
- who can have contact with you;
- what you can eat;
- what kinds of activities you can participate in; and
- what kinds of licenses or permits you can get.
c) Healthcare Decisions
In a section 7 representation agreement, you can authorize your representative(s) to make the following healthcare decisions on your behalf:
- routine tests;
- routine dental treatment;
- major surgery;
- any treatments involving a general anesthetic;
- major diagnostic or investigative procedures;
- radiation therapy;
- intravenous chemotherapy;
- kidney dialysis;
- electroconvulsive therapy;
- laser surgery; and
- request medical and hospital records.
What a Section 7 Representative Cannot Do
A representative named in section 7 representation agreement cannot:
- obtain a credit card or line of credit for you;
- buy or sell real property on your behalf;
- guarantee a loan or indemnify a third party on your behalf;
- refuse consent to life-supporting treatment or care;
- decide whether you can be forced to receive psychiatric care in a mental health facility;
- agree to abortion or treatments that would sterilize you;
- remove an organ or tissue for transplant, education, or research;
- agree to experimental health care that has not been approved by an ethics committee;
- physically restrain or move you despite your objections;
- make decisions about the temporary care and education of any of your children; or
- interfere with any religious practices you have.
Benefits of a Representation Agreement
Here are some reasons why you should make a representation agreement:
1. you can legally appoint a representative to make healthcare decisions for you;
2.you can empower your representative to make personal care decisions for you;
3. you can rest easy knowing that your representative must follow your known wishes and beliefs;
4. your representative will have access to your medical and can advocate for you in an informed manner;
5. you can specify your wishes relating to end-of-life decisions, including refusing or withdrawing consent to treatments necessary to prolong life;
6. you can specify when the representation agreement and representatives powers come into effect; and
7. you can identify generally (for example, major health care decisions as opposed to minor health care decisions) and specifically (for example, abortion, electroconvulsive shock therapy) the decisions your representative can or cannot make.