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Choosing Your Healthcare Representative
Who will speak for you?
Thinking about future medical care can feel overwhelming. Choosing a medical spokesperson ahead of time brings immense peace of mind. It ensures your healthcare wishes are respected and relieves your family from making difficult guesses during a medical crisis.
⚠️ Important Notice About Legal Terminology in B.C.
If you are searching for a "Medical Power of Attorney" or a "Living Will," you are likely using terms from other provinces or American media. In British Columbia, these terms do not exist in healthcare law:
Power of Attorney (POA):
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A power of attorney is a legal document that appoints another person, called an “attorney,” to deal with your business and property and to make financial and legal decisions on your behalf. A power of attorney can be very specific or very broad.
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A power of attorney ends if you become mentally incapable. If you want the power of attorney to continue even if you become mentally incapable of making financial decisions, you should make an enduring power of attorney.
Enduring Power of Attorney:
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An enduring power of attorney is a legal document that appoints another person to make financial and legal decisions for you. Here is the EPOA document to download. *The document must be printed on paper; BC laws do not allow an EPOA to be solely stored as a digital or online-only file.
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An enduring power of attorney will continue even if you become mentally incapable of making decisions. It is different from an ordinary (non-enduring) power of attorney, which ends if you become mentally incapable.
To create an enduring power of attorney, the document must be properly signed, and must state:
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whether the attorney (the person appointed to make decisions) can act while you are capable or only while you are incapable, and
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that the attorney’s authority continues despite your incapability.
Representation Agreements:
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The official legal document used in B.C. to name a trusted person (your Representative) to make medical and personal care decisions for you if you become too sick or injured to speak for yourself.
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With a representation agreement, you can choose someone you trust to be your legal representative, and they may also be given decision-making authority for your personal care and health care, and in some cases, the routine management of your financial affairs, including legal matters.
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Your representative does not need to be a family member. They should be someone who knows you well and can handle pressure.
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When choosing, look for someone who:
a) Is at least 18 years old.
b) Understands your personal values and philosophies on life and death.
c) Can make tough choices under intense emotional stress.
d) Will advocate firmly for your wishes, even if other family members disagree.
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For end-of-life care planning, adults typically complete a Section 9 (Enhanced) Agreement. This gives your representative the legal authority to make major, critical health decisions, including the choice to accept or refuse life support and authorize palliative or hospice care.
What Happens If You Do Not Name Anyone?
If you suddenly become incapable of making choices without an agreement in place, B.C. law assigns a Temporary Substitute Decision Maker (TSDM).
Your healthcare provider selects this person from a strict legal hierarchy (starting with your spouse, then adult children, then parents, then siblings). If you want to choose exactly who speaks for you—or if you want a close friend rather than what the default law dictates—you must complete a Representation Agreement.
Local Steps for Salt Spring Island Residents
Step 1: Get the Forms:
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The provincial government publishes a comprehensive guide called My Voice: Expressing My Wishes for Future Health Care. It includes all the official, fillable B.C. forms for Representation Agreements. You can download here or visit the Salt Spring Hospice Society office (202-118 Fulford Ganges Rd), where they will provide you with a physical copy, free of charge.
Step 2: Sign and Witness Correctly:
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To make your Representation Agreement legally valid, you must sign it in front of two witnesses, who must also sign it in your presence. Alternatively, you only need one witness if that person is a practicing B.C. lawyer or a member of the Society of Notaries Public of B.C.
Step 3: Share with Your Local Care Team:
Once your documents are signed, do not store them away in a hidden safe. Deliver copies directly to:
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Your designated Representative(s).
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Your family doctor or nurse practitioner at local offices like Kings Lane Medical Clinic or Salt Spring Health Centre.
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Island Health. Ask your doctor to submit your forms to the Island Health electronic medical record system. This ensures they can be instantly viewed if you are admitted to the emergency room at Lady Minto Hospital or anywhere else on Vancouver Island.
Need Local Assistance?
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If you live on Salt Spring Island and need help navigating these forms, understanding the steps, or simply talking through your wishes, please connect with the Salt Spring Hospice Society. Our trained volunteers and staff provide free, confidential guidance to help you complete your paperwork.
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You can also call the Island Health Advance Care Planning Information Line at 250-370-5687 for localized support across our health authority region.