Nova Scotia·Health Hacks

Making sure your medical wishes are followed if you become incapacitated

Advance directives can provide a way for patients to ensure their wishes are followed when they can’t speak for themselves, according to health-care consultant Mary Jane Hampton.

Advance directives can outline treatments and interventions patients do not want

Patients should distribute copies of their advance directives to a delegate, trusted family and friends and the health-care workers looking after them. (Shutterstock)

This is part of a series from CBC's Information Morning where Halifax health-care consultant Mary Jane Hampton discusses her "health hacks" — ways to make your experience with the health-care system better.

Patients have the right to refuse treatment — but if they're incapacitated, they might not have the ability to make those important decisions.

That's what advance directives are for, according to health-care consultant Mary Jane Hampton.

"This is a document that spells out what you want to happen to you when you are alive but maybe close to death, or when you are alive and not able to speak on your behalf," Hampton told CBC's Information Morning.

Hampton said it's important for people to begin thinking about what kind of treatments or interventions might be carried out if they have a medical emergency, or if there is a point that a disease might render them incapacitated.

They should then consider the effects of these hypothetical situations on their quality of life, and pinpoint what they don't want to happen to them.

Mary Jane Hampton, a Halifax-based health-care consultant, says it's important for people to start thinking about what kind of treatments or interventions might be carried out if they have a medical emergency. (Robert Short/CBC)

"It's remarkable how few people actually think of that, and yet for a lot of us it's in the back of our minds fairly often," said Hampton.

For example, if someone has a stroke and they're unconscious, and it's clear that they will be paralyzed, there may be a question as to whether they would want to be resuscitated if their heart stops.

"Some people would say, 'yes, absolutely, because I would like everyone in the health system to do everything that is scientifically possible to save me,'" said Hampton.

"Other people would say, 'no, not so much, I would actually draw the line at that.'"

In a case like that, the health-care professionals can check the patient's advance directive to see if they outline specific interventions they don't want.

'We have the right to say no'

If someone doesn't have an advance directive, typically someone would be appointed to speak on their behalf, like a spouse or family member.

If those people are not available, then a public trustee would be appointed to represent their best interests — though Hampton said it's not ideal for a stranger to make these kinds of decisions.

"Think that scenario through, and if you're not comfortable with that, take some steps to ensure that your personal wishes would be understood and respected," she said. 

"We have the right to say no, but people need to know that you want to say that."

Hampton said it's also important for patients to ensure their advance directives are up-to-date.

"Somebody who is in their 30s may have a very different set of personal directives than people who are in their 80s," she said.

The advance directive form can be found on the Nova Scotia government website. (Alex Cooke/CBC)

In order to create a personal directive, the patient must fill out a form outlining their decisions and have it signed by a witness. The form can be found on the Nova Scotia website.

If they want, they can also choose a delegate who can be trusted to make personal care decisions when they are not capable of making those decisions themselves.

Hampton said that it's also a good idea for patients to distribute copies of the directive to the delegate, trusted family and friends, and the health-care workers looking after them.

"Once you've done all of those things, you can kind of rest easy," she said.

"If something happens that you can't speak for yourself in the case of a medical emergency, at least the people who are caring for you will know what it is that you would have wanted."