Advance medical directives to plan for your health care if you become incapacitated

Directives used in certain situations only

The advance medical directives you’ve prepared will serve as a reference document for health professionals only if the following two conditions are met:

1. You're no longer capable of giving consent to care.
2. You’re in one of the following three situations specified by the law:

• • You suffer from a serious and incurable medical condition and are at the end of life.
  • You're in a coma deemed irreversible or in a permanent vegetative state.
  • You have serious dementia with no possibility of improvement. In the medical community this is also referred to as “major neurocognitive disorders” (e.g., Alzheimer’s disease).

Did you know?

The inability to take care of yourself must not be confused with the inability to consent to care. An individual may be considered incapable of managing his or her property and finances, but capable of making decisions concerning his or her health care.

Therefore, individuals represented by a mandatary or a tutor may be capable of consenting to their own care. It’s important to look at each situation on a case-by-case basis.

Consenting to health care for the incapable person (Gouvernement du Québec)

Only five treatments can be decided in advance

You can use advance medical directives to express your wishes concerning the following five treatments:

• Cardiopulmonary resuscitation
• Ventilator-assisted breathing or breathing assisted by another technical support
• Dialysis
• Forced or artificial feeding
• Forced or artificial hydration

Therefore, you cannot use advance medical directives to express your wishes concerning medical aid in dying.

Requirements to issue advance medical directives (Gouvernement du Québec)

Have you expressed your wishes concerning these five treatments in other documents?

You may have expressed your wishes concerning these five treatments in documents other than your advance medical directives, such as your protection mandate (previously called a “mandate in case of incapacity”).

If this is the case, it’s important to note that advance medical directives take precedence. Therefore, medical staff will follow these directives even if your protection mandate is more recent.

Your advance medical directives will also take precedence over the opinion of the persons close to you, your mandatary, or your tutor.

What if you change your mind?

If you wish to modify the choices in your advance medical directives, you can draft new ones as long as you’re capable of giving consent to care.

If you wish to cancel your advance medical directives, you can follow the revocation procedure with the RAMQ.

Also, if you become incapable of giving consent to care but categorically refuse to receive a certain type of care, the medical team must not administer the refused care even if you consented to it in your advance medical directives. However, in this situation, a court may order that you receive it. 

To learn more about how to modify or cancel your advance medical directives, please consult our “How to prepare advance medical directives” page.