If not you, who will make your medical decisions?

Editor’s Note: April 16 is Advanced Care Planning Day.

Imagine finding yourself in a medical emergency, unconscious and unable to communicate. In such a critical moment, health-care professionals need to act swiftly, and they need to know your wishes for treatment and care. But here’s the catch – you can’t tell them.

So, who becomes your voice in this complex web of health-care decisions? It’s a question many of us would rather avoid, yet it demands an answer. Enter Advance Care Planning (ACP), a process empowering you to choose that guiding person who will champion your health and personal care preferences.

Salome, a 79-year-old Inuk woman who lives in a rural, isolated community in Northern Canada, is a real-life example of how ACP can relieve the burdens and pressures on families, support networks and medical care givers.

Salome has suffered from multiple chronic health issues over the years and has recently been diagnosed with congestive heart failure. Her husband previously had been designated to make health-care decisions on her behalf if she was no longer able to, but he recently died. Salome, though, has a large family for support, including 11 children, who are all actively involved in her care. Knowing she has major health concerns, and to avoid any conflict between her children should her health deteriorate, Salome appointed her eldest daughter, Sophie, as her substitute decision-maker. Salome is confident that Sophie will honour her health-care wishes, ensuring that the cultural aspects of care provision are at the forefront.

Salome’s story illustrates that ACP is not an abstract concept; it’s a proactive, empowering process allowing you to designate someone to uphold your wishes and the type of health-care decisions you would want. While defining and expressing wishes can be challenging, they can reduce uncertainties for health-care professionals and those who matter most to you. Like Salome, it is important to take the time to consider who you trust with these vital choices – be it a family member, a friend, or someone you hold in high regard.

It is important to take the time to consider who you trust with these vital choices.

Advance Care Planning – The basics

ACP is a lifelong process of thinking and talking about the kind of health and personal care you would want if – at some point in your life – you cannot communicate for yourself. Advance Care Planning involves reflecting on your values, beliefs, and wishes, and sharing this information with the person or people you’ve chosen to speak up for you. The goal is to ensure they understand what you value most. The process is often accomplished through five steps:

  1. THINK about what is most important to you – your values, wishes and beliefs.
  2. LEARN about your overall health, including any current conditions you want to better understand.
  3. DECIDE on your Substitute Decision Maker(s) – people willing and able to speak for you if you cannot.
  4. TALK about your values, beliefs and wishes with your Substitute Decision Maker(s), family, friends and health-care providers.
  5. RECORD your values, wishes and beliefs in your Advance Care Planning Workbook, or make a video, audio recording or use any format that suits you.

With our health-care system grappling under immense pressure, prioritizing health-care planning offers reassurance, alleviating emotional burdens, stress and uncertainty – for you, your support network and your health-care providers. While these initial steps may appear daunting, numerous free tools and resources are available to guide you through the process. The ACP Canada reflection prompts, for instance, serve as an ideal starting point to help you think about what truly matters to you.

Your wishes matter 

This moment is yours. Advancecareplanning.ca offers tools and resources to help guide you through the process of reflecting on your values, having those crucial conversations, and designating your healthcare decision maker(s). ACP is not just about paperwork; it is your chance to make sure your wishes are part of your health-care story, no matter what the future holds.


  1. Advance Care Planning Canada — 5 Steps Video
  2. ACP 5 Steps Postcard
  3. ACP Day Reflection Prompts
  4. ACP Canada Living Well, Planning Well Toolkit

The Advance Care Planning Canada initiative, led by the Canadian Hospice Palliative Care Association (CHPCA), focuses on advancing the Pan-Canadian Framework for Advance Care Planning. The ACP initiative works in collaboration with various sectors and professional groups to accomplish our goals.

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Karine Diedrich


Karine Diedrich is the Director of Advance Care Planning Canada at the Canadian Hospice Palliative Care Association. With 15 years of experience in the non-profit sector, Karine specializes in partnership development, strategic planning and communications, working collaboratively to address complex challenges in health care engagement and innovation.

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