Substitute decision maker

Hierarchy

• There is a hierarchy of SDMs under the Health Care Consent Act in Ontario
• If there is more than one party in a given step, then they are considered equal ranking and must all be contacted
• For the legally-appointed SDMs, they must provide documentation

1. Legally-appointed SDMs
   1. Court-appointed guardian
   2. Attorney for personal care
   3. Representative appointed by the Consent and Capacity Board
2. Automatic family member SDMs
   1. Spouse or partner
   2. Parents or children
   3. Parent with right of access only
   4. Siblings
   5. Any other relative
3. SDM of last resort
   1. Public Guardian and Trustee

Qualifications

• The SDM must be:
  • Capable to make the decision
  • At least 16 unless they are the parent of the patient
  • Not prohibited from serving as SDM by court order or separation agreement
  • Available within a reasonable time frame
  • Willing to assume responsibility for the decisions