You say Proxy, I say Power of Attorney:
Don’t let terminology stop you from making a plan

Perhaps one of the most confusing aspects of advance care planning involves the terminology used across Canada to identify the individual who will speak on your behalf when you can’t speak for yourself, and the document through which you might appoint someone to do so.

Perhaps you have named a person to make your decisions already. Depending on where you live, this person may be called a Substitute Decision-Maker, a Surrogate Decision-Maker, a Medical Proxy or a Health Representative.

You may have also prepared a document describing your wishes for care – such as an Advance Care Directive, Power of Attorney for Personal Care form or a Living Will.

Over the past 15 – 20 years, legislation has been enacted in almost all provinces and territories to ensure the right of a capable adult to appoint another person to make decisions in the event of incapacity – but because health care is provincially governed, these laws and the terminology used differ across the country. It’s easy to see how this can quickly become confusing, especially if family members live in different locations across the country.

A list of provincial / territorial resources is available at the Speak Up website to provide guidance about advance care planning terms and legislation. The National Advance Care Planning Task Group suggests that you identify a substitute to speak for you when you cannot, regardless of what that person is called in your province.

You can name your substitute in a written document, and have a lawyer help you prepare it or provide advice about what to include in your plan. Of course, the most important thing you can do is to have a conversation with your substitute so that he or she can make decisions on your behalf and in accordance with your wishes, rather than having to guess what you’d want.

Don’t let terminology stop you from making a plan. Use the resources at to better understand how to make a plan that will work for you – and start the conversation about end of life care.

Louise Hanvey is a practicing Registered Nurse and the Project Manager for Advance Care Planning in Canada.