3. Learn how a substitute decision-maker is selected

You may be able to choose your substitute decision-maker (SDM). If you cannot, the law says who will become your SDM.

Choose a substitute decision-maker

You can choose your own SDM.  You do this by naming them in a Power of Attorney for Personal Care (POA) and signing it. Even if you're not able to agree to treatment, you can still sign a POA if you understand:

• whether the SDM you choose really cares about what's good for you, and
• that the SDM you choose may need to make decisions for you about your care.

You have to follow certain rules when making a POA. You can get a lawyer to help you prepare a POA. Many people sign a POA a long time before they become sick.

If you change your mind about your SDM, you can make a new POA as long as you're still able to understand what an SDM does and whether the new person you choose really cares about you.

Automatic substitute decision-maker

If you don't choose your own SDM, the law says these people can be your SDM:

• your spouse or common-law partner
• your child, if they're over the age of 16, or your parents if they have decision-making responsibility or custody of you
• the Children's Aid Society or whoever has a legal right to give or refuse consent to the treatment, in the place of the parent
• your parent, if they don't have decision-making responsibility or custody but they have parenting time or access
• your brother or sister
• any other relative by blood, marriage, or adoption

Your SDM will be the person closest to the top of the list who's available, capable, and willing to decide about treatment for you. They don't have to apply to be your SDM. It's automatic, so your doctor can ask them for permission right away.

If there's more than one person at the same level on the list, for example, if you have 2 children, they may decide together or they may choose one of them to be the SDM.