Making Health Decisions for Others


Photo © Courtesy of Hospice Palliative Care Ontario

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Heartbreaking and challenging conversations happened worldwide as people rapidly deteriorated from COVID-19. People found themselves being asked by healthcare providers to make critical treatment decisions for their loved ones.

It’s not just for COVID-19. You may not know it, but you’re probably a Substitute Decision Maker (SDM) for someone. That means healthcare providers will ask you to make decisions if, for any reason, that person becomes mentally incapable of speaking up. Are you ready?

“As an SDM, you may be asked to make a variety of healthcare decisions and it’s hard to guess what they will be. But even without knowing specifics, you can prepare. Begin by talking ahead of time, when the person is well. Learn what’s important to them, what they value most about their own health and wellbeing, and their health-related worries and fears.”

Even in situations where the person can no longer talk to you about their wishes, thinking about how they might have answered those questions is a place to start. When you make decisions, you will combine what you know about the person with the medical information provided by the healthcare team.

Nadia Incardona_Headshot
Dr. Nadia Incardona Photo © Courtesy of Hospice Palliative Care Ontario

Dr. Nadia Incardona, an ER physician at Michael Garron Hospital in Toronto, witnesses first-hand how SDMs struggle to make complex healthcare decisions when their family members face a sudden or serious illness. She’s part of Palliative Care Ontario’s expert team that developed a kit to help people have these conversations. The kit will help you learn more about who you might be asked to make healthcare decisions for, and suggests how to start talking about what matters most in life, illness, and dying.

“It’s not just talking about life support or end-of-life situations. Learn what quality of life means to the person. It may be different than you think. Medical treatments come with harms or risks so try to understand what they would find acceptable—or not. Making decisions for another person still isn’t easy; for most, there are emotional connections to the person you’re making decisions for. But having these conversations in advance may make it easier.”

It’s called Advance Care Planning. Go to

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HPCO’s Speak Up Ontario promotes Ontario specific Advance Care Planning, Goals of Care, and Health Care Consent information, tools, and resources.


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