Updated: April 2025  |  bremo.io financial guides

Living Wills and Advance Directives in Canada

A "living will" is an informal term for a document that records your wishes about medical care in advance — particularly end-of-life treatment — in case you become unable to communicate those wishes yourself. In Canada, these documents go by different names depending on the province, but they all serve the same fundamental purpose: ensuring that your healthcare preferences are known and followed even when you cannot speak for yourself.

What a Living Will Is (and Is Not)

Despite the word "will" in its name, a living will has nothing to do with inheriting assets. It is not the same as a last will and testament. A living will (or advance directive) is about healthcare decisions during your lifetime. It only applies while you are alive but incapacitated. At the moment of death, your regular will takes over for the distribution of your estate.

Provincial Names for Advance Directives

Canada does not have a single national standard. Each province has its own legislation and terminology:

• Ontario: Power of Attorney for Personal Care (can include specific care wishes)
• British Columbia: Representation Agreement and Advance Directive
• Alberta: Personal Directive
• Saskatchewan: Health Care Directive
• Manitoba: Health Care Directive
• Nova Scotia: Personal Directive
• New Brunswick: Advance Health Directive
• Quebec: Advance Medical Directives (mandats de protection and directives médicales anticipées)

What an Advance Directive Can Cover

You can include guidance on a wide range of healthcare decisions:

• Whether you want cardiopulmonary resuscitation (CPR) if your heart stops
• Use of mechanical ventilation (breathing machines)
• Artificial nutrition and hydration (feeding tubes)
• Dialysis
• Antibiotics and other medical interventions in terminal illness
• Palliative care preferences (pain management, comfort care)
• Preferences about dying at home vs. in hospital
• Organ and tissue donation wishes
• Medical Assistance in Dying (MAID) — your values about this option

The Importance of Naming a Healthcare Proxy

An advance directive records your wishes on paper. But medical situations are complex and rarely fit neatly into pre-written scenarios. This is why naming a healthcare proxy — someone who can interpret your wishes and make real-time decisions in situations your document did not anticipate — is equally important. Your proxy (called your "attorney for personal care" or "representative" depending on province) should know your values well and be willing to advocate for you under difficult circumstances.

What Happens Without an Advance Directive

Without an advance directive or healthcare proxy, medical decisions fall to your family by default — but not always in the order or manner you might expect. The medical team will consult your next of kin, but there may be disagreement among family members, and some provinces do not have clear legal authority for family members to act as substitute decision-makers without a formal document. The result can be unnecessary interventions, family conflict, and outcomes that do not reflect your wishes.

Does an Advance Directive Override Doctors?

An advance directive guides medical care, but doctors retain their professional and ethical obligations. They will not follow instructions that require them to act against medical standards or the law. However, they must give substantial weight to clearly expressed wishes about refusing or withdrawing treatment. In most provinces, a valid advance directive creates a legal obligation for healthcare providers to honour your stated wishes to the extent medically and legally permissible.

Creating a Valid Advance Directive

The requirements vary by province, but general steps include:

1. Write your wishes clearly — use specific language about treatments you want or do not want
2. Have the document witnessed (requirements vary; some provinces require a commissioner for oaths)
3. Store the document where it will be found — consider registering it if your province has a registry
4. Give copies to your healthcare proxy, family doctor, and any specialists you see regularly
5. Review and update it periodically as your health situation or values change

Medical Assistance in Dying (MAID) and Advance Directives

As of 2024, the law on whether advance directives can authorize MAID in Canada is evolving. Currently, a person must have the capacity to consent at the time MAID is administered in most situations, though legislative changes affecting people who have been assessed and approved before losing capacity are being phased in. This is an area where laws are actively changing; discuss your wishes with your physician and legal advisor.

Putting It All Together

A complete plan for incapacity and end of life includes:

• A continuing/enduring power of attorney for property
• A power of attorney for personal care or equivalent healthcare proxy designation
• An advance directive recording your specific care wishes
• Conversations with your proxy, family, and doctor

These documents work together and should be prepared at the same time as your will, stored in an accessible location, and updated whenever your situation or values change significantly.