Medical and End-of-Life Decision-Making Under a Power of Attorney for Personal Care in Ontario
How Medical Decisions Are Made When You Can’t Speak for Yourself
If you lose the ability to understand or communicate medical information, Ontario law requires that a substitute decision-maker (SDM) step in. If you’ve made a Power of Attorney for Personal Care (POAPC), your chosen attorney becomes that SDM.
Your attorney can make decisions about:
treatment consent – approving or refusing surgeries, medications, or other therapies;
hospitalization and discharge – deciding where you receive care;
personal support – such as diet, hygiene, or safety measures; and
end-of-life choices – including palliative care, life-support continuation or withdrawal, and comfort measures.
They are legally bound to follow your expressed wishes whenever possible. They cannot decide on medical-assistance-in-dying on your behalf.
Your Wishes Come First
Ontario’s Health Care Consent Act gives priority to your own prior capable wishes — meaning if you clearly stated your preferences while capable, your attorney must follow them.
This can include:
whether you want to be kept alive on life support;
preferences about pain management or resuscitation;
organ donation consent; and
religious or cultural considerations in treatment.
If your wishes aren’t known, your attorney must make decisions in your best interests, considering your values, beliefs, and quality of life.
You can make your attorney’s job easier and protect your dignity by:
including your preferences directly in your Power of Attorney for Personal Care;
writing a Living Will or Advance Directive and attaching it to your POA; and
discussing your values openly with your attorney and family before a crisis occurs.
The more guidance you provide, the less stress and uncertainty your loved ones will face.
The Role of Health Professionals
Doctors, nurses, and care teams must obtain informed consent before giving treatment.
If you’re incapable of providing it, they must turn to your attorney for personal care.
Your attorney has the right to:
ask questions and receive complete medical information;
request a second opinion or refuse treatment; as well as
consent to or withdraw treatment, ideally based on your known wishes.
Healthcare providers must respect valid POAs, and disputes can be referred to the Consent and Capacity Board, an Ontario tribunal that resolves such matters.
End-of-Life Care and Ethical Decisions
End-of-life decisions are emotionally and morally complex.
A POAPC ensures that your own values—not the default assumptions of others—guide these moments.
Examples of wishes you might clarify in advance include:
whether to receive life-prolonging treatments such as ventilators or feeding tubes;
preferences for comfort care or palliative settings over hospital care; as well as
decisions about organ or tissue donation.
When these instructions are clear, your attorney can act confidently and compassionately on your behalf.
Disagreements among relatives are common in medical crises.
A valid POAPC helps prevent disputes by giving one or more trusted individuals clear legal authority.
You can reduce confusion further by:
telling your family who your attorney is and why;
sharing your written wishes with key relatives and healthcare providers; and
keeping copies of your POAPC in accessible locations, such as with your lawyer or physician.
Transparency today prevents conflict tomorrow.
Final Thoughts
A Power of Attorney for Personal Care is more than paperwork — it’s a statement of autonomy and compassion.
It ensures your health care aligns with your principles, even when you can’t speak for yourself, and provides comfort to those who must act in your stead.
Take the Next Step
Make sure your medical and end-of-life wishes are respected. Complete our online form to automatically generate your Ontario-compliant Power of Attorney for Personal Care, ready for signing and witnessing — because your choices deserve to be honoured.