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If You Can’t Speak For Yourself in Health Care Situations.

If You Can’t Speak For Yourself in Health Care Situations.

Advance Care Planning is the process of confirming who your Substitute Decision Maker is, or the person who will speak for you if you are mentally incapable of speaking for yourself in health care situations.  The COVID-19 pandemic has put a sharp focus on ACP

“We can’t know what health care decisions we may face in the future, but we know what quality of life means to us and what’s important to us when we make health-care decisions,” says Hospice Palliative Care Ontario President and CEO, Rick Firth. “And, a Substitute Decision Maker needs to know that too.”

Today  is National Advance Care Planning Day in Canada, and Hospice Palliative Care Ontario is urging everyone to take some time to consider the values and wishes that inform their health care decisions. 

“Health care decisions are not always clear cut and consent can’t be granted ahead of time,” explains Mr. Firth. “Treatment options come with pros, cons, and possible risks and benefits, and those are based on multiple factors that will vary over time – age, overall health, extent of illness or injury, and context.  That’s why it’s important to talk about your values and wishes and not specific treatments.”

Ontario law automatically designates someone as your Substitute Decision Maker (SDM) – typically a spouse, child or other relative. But you can designate anyone. 

“You can go to Speak Up Ontario website and click on individual and family resources to find the Substitute Decision Maker hierarchy. If you aren’t satisfied with your legally designated Substitute Decision Maker, you can appoint a Power of Attorney for Personal Care.” (POA for personal care form)

Whomever it is – that person needs to know what’s important to you. If you can’t speak for yourself, health care providers will turn to your Substitute Decision Maker to have a goals of care conversation. Essentially, it’s about what outcomes are likely and hoped for from health care treatments, and what the downsides might be.  The discussions can sometimes happen fast, with little time to think, and during a stressful and emotionally difficult time, ” says Mr. Firth.

“Thinking and talking in advance, having Advance Care Planning conversations, and checking in regularly with your SDM about what your expectations and hopes are for life, can help you or your SDM make the right decision for you,’’ adds Mr. Firth. “Go to for tips. It can happen to any of us, any time.”

Contact:  Jennifer Mossop 519-619-2227 or

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