Who can speak on behalf of seniors with no next of kin?

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  • Paul Taylor says:

    Hello Judith:

    The points you make are absolutely correct. There is a legal structure in place for dealing with people who can’t speak for themselves. And that is a good thing.

    But there is a difference between having a decision made on your behalf by a stranger compared with someone who knows your wishes.

    Will your life be prolonged or shortened if the decisions for your care are made by a person who does not know you?

    I wanted to provided this woman with some idea how she can take steps to pass on her wishes for her end of life care while she and her husband can still speak for themselves.
    And I think that is the information most people in their situation want to know.

  • Judith Wahl, Barrister and Solicitor and Executive Director says:

    Two important points are missing here.
    First- In Ontario EVERYONE always has an SDM for health decisions even if they never completed a POA Personal Care. The Health Care Consent Act includes a hierarchy of substitute decision makers who woudl act for a patient if the patient became mentally incapable of health decisions. The person or person highest ranking in that hierachy that meet the qualifications to act as an SDM ( qualifications include being capable themselves, being available and willing to act as SDM etc) would be entitled to act as the patinets SDM . That list includes the attorney named in a POA, the spouse or partner of the patient , children and parents of the patient, as well as brothers and sisters of the patient but it also includes ANY other relative of the patient related by blood , marriage, or adoption so the SDM is not always a “close” relative.

    second point is that if someone has no one from that hierachy capable available and willing to act then the Public Guardian and Trustee MUST step in to act as the patients SDM – hence everyone in Ontario always has an SDM

    This, as well as the basics on health care consent and advance care planning are explained on the following Tip Sheets available on the Website for the Advocacy Centre for the Elderly

    Health Care Consent and Advance Care Planning
    Hierarchy of Substitute decision makers

    ACE will be producing more free publications and information on Health Care Consent and Advance Care planing in the near future all of which will be available on the ACE website.


Paul Taylor


Paul Taylor is a health journalist and former Patient Navigation Advisor at Sunnybrook Health Sciences Centre, where he provided advice and answered questions from patients and their families. Paul will continue to write occasional columns for Healthy Debate.

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