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DeDominicis: Appoint someone to make your health care decisions

A representation agreement names someone to make health care decisions for you if you become mentally or physically unable.

A representation agreement is a legal planning document which can be used in British Columbia to provide your named representative the authority to make health care decisions for you if you are unable to do so because of mental or physical disability. Living will language can also be incorporated into a representation agreement which provides the named representative the legal right to refuse specific medical treatment or any treatment at all.

A representation agreement gives you the opportunity to appoint a person of your choice to make health care decisions for you on an ongoing basis. You set out in what circumstances consent to treatment is to be given on your behalf by your representative and in what circumstances it is not to be given. As well, you can specify acceptable types of treatment.

The representation agreement enables you to choose who will make the decisions regarding your personal care and health matters when you cannot. As well, it provides you with the flexibility to choose more than one person so that two or more people have to act together to make the necessary decisions. You can also stipulate whether one representative can break a tie or has a veto; and choose an alternate representative in the event the person(s) you have chosen are unable or unwilling to act at the time.

A representative who has authority over an adult’s personal care or health care is under strict obligations in regards to record keeping. He/she must keep the following records in relation to personal care or health care of the adult:

• a copy of any record made by the adult of the adult’s instructions, wishes, beliefs and values

• if there are any changes in the adult’s residence, or needs with respect to personal or health care, the representative must record the nature of the change and the decision made by the representative in respect of it

• if the representative made a major health care decision or admitted the adult to a care facility, the representative must describe why the decision was made and the date of that decision

• if the representative decides to restrict a person from associating with the adult, the representative must explain why; and

if the adult was physically restrained, moved or managed, the representative must describe who restrained the adult and why.

Proper planning is essential. Representation agreements provide a great deal of flexibility when it comes to planning for incapacity in the delegation of decision-making authority for personal care and health matters.