Specific decision-making

A one-time decision

If an adult has lost the ability to consent to health-care treatment or where they live, a health-care provider can choose one of the adult’s relatives to make the decision.

Specific decision-making is only used when there is no decision maker in place – through guardianship or an agent under a personal directive – and when the authority area is not included.

The specific decision will deal with the adult’s:

• healthcare:
  • procedures
  • examinations
  • treatments
• temporary placement to, or discharge from, a residential facility, including:
  • nursing homes
  • rehabilitation centres
  • approved hospitals
  • auxiliary care
  • licensed group homes

How specific decision-making works

Step 1. Assess the adult

A health-care provider, such as a doctor, nurse practitioner or dentist, completes a capacity assessment to determine if the adult is incapable of making a health care or residential living decision.

Step 2. Select a specific decision-maker

A health-care provider selects a decision-maker who meets both sets of criteria below.

General criteria

A specific decision-maker must:

• be 18 years old or older
• be available and willing to make the decision
• have had contact with the adult within the past 12 months
• have no disputes with the adult
• have knowledge of the adult’s wishes, beliefs and values

Ranked-list criteria

In addition to the general criteria, a specific-decision maker must also be a relative of the adult from this ranked list:

• spouse
• partner in an adult interdependent relationship, which means:
  • interdependence with another adult for 3 years
  • less than 3 years if you have signed an Adult Interdependent Partnership Agreement
  • less than 3 years if you have had a biological child together
• adult son or daughter
• father or mother
• adult brother or sister
• grandfather or grandmother
• adult grandson or granddaughter
• adult uncle or aunt
• adult niece or nephew

Step 3. Make a decision

The specific decision-maker makes a decision that must:

• reflect the adult’s wishes, values and beliefs
• consider the benefits and risks of treating the adult, including:
  • quality of life
  • overall health
  • living situation
• respects the individual’s rights and freedoms

Step 4. Fill out the form

A health-care provider describes the decision in this form:

Form 6: Specific Decision-making

The specific decision-maker completes and signs Form 6, which makes the decision official.

After the decision

The specific decision-maker must try to contact the adult’s next closest relative to inform them of the decision.

If the adult has no other relative, the specific decision-maker must notify the OPGT about the decision.

Disagreeing with the decision

A health-care provider can act on the decision if a person who disagrees with the decision does not take action within 7 days.

Disagree with the completed capacity assessment

If someone – the adult or a person who has a close relationship with them – believes the adult can make their own decision, they have 7 days to do one of these things:

• request a new capacity assessment through a Capacity Assessment Report – Form 10
• apply to the court to have the first capacity assessment reviewed

Disagree with the decision that has been made

If someone – the adult or a person who has a close relationship with them – disagrees with the decision, they have 7 days to:

• apply to the court to have the decision reviewed

The health-care provider must be notified that a review is being requested. The decision cannot be acted on until the adult’s capacity or the decision has been reviewed.

Legal advice

Consult a lawyer for legal advice if you want the court to review the decision.

Publications

• Specific Decision-Making
• Decision-Making Options: Adult Guardianship and Trusteeship Act

Contact

Find an OPGT office near you