People sometimes use the terms “advance care plan” and “living will” interchangeably. Both include written instructions about the care you would want to receive if you become incapable of speaking for yourself, and about who would speak for you in those circumstances – but that’s where the similarities end.

The term “living will” originated in the United States and has no legal status in Canada. It is sometimes used to refer to a document that describes the care a person would and would not want to receive if he or she is not able to communicate his or her wishes about treatment. If such a document is used in Canada, it may be known as an advance directive, or may be a “wish” (or series of wishes) incorporated into a Power of Attorney for Personal Care. Although forms and processes vary from province to province, documents such as Powers of Attorney for Personal Care are generally used to appoint a substitute decision-maker (called the “attorney” when appointed through a Power of Attorney for Personal Care) to make decisions when a person is not able to do so. Powers of Attorney for Personal Care may, but do not have to, set out the person’s wishes regarding care and treatment. The document (and regulations around them) vary from province to province.*

An advance care plan is so much more. While it’s a great idea for anyone to write down their thoughts and feelings about the care they would want, it’s even more important for them to have conversations with others about those wishes, especially their substitute-decision maker, their family and their health care team. It’s also a good idea for a person to discuss plans and wishes with their lawyer and others who represent their interests.

A living will is a document that reflects a person’s wishes at the time that he or she creates and signs it. But advance care planning is a process that goes beyond one document, or even one conversation. Life changes, and so may a person’s wishes for care over time.
If you have a plan, make sure you take the time to reflect on your plan, especially during milestones in your life, or when there’s a major change, such as a marriage, death or divorce.
Advance care planning is about conversations, decisions, and identifying how people would like to be cared for. If you choose to engage in this process, make your advance care plan really “live” – with conversations that give your loved ones the knowledge and confidence to act on your behalf without guilt or worry. Make sure your voice is heard.

Lonny J. Rosen, C.S. is a Toronto-based health law lawyer and is a partner of the law firm Rosen Sunshine LLP. He is certified by the Law Society of Upper Canada as a Specialist in Health Law, and has served as the Chair of the Health Law Sections of both the Canadian and Ontario Bar Associations. He is a member of the National Advance Care Planning Task Group.

*for more information about provincial /territorial resources, please visit our website: /making-your-plan/how-to-make-your-plan/provincial-territorial-resources.aspx