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End-of-life care in estate planning

When it comes to end-of-life decisions, proper planning is crucial. In Ontario, estate planning documents may include a health care directive that provides the Substitute Decision Maker (SDM) with guidance about the patient's wishes regarding end-of-life medical treatment. Such guidance would be extremely helpful for the appointed SDM when a serious decision has to be made under very stressful circumstances.

It is invaluable to the family and friends when the patients, takes the time to write down their end-of-life wishes regarding health care before becoming incapacitated. The family, the appointed SDM (aka attorney for personal care) and the medical personnel will have direction as to what the patient would like to have happen when it comes to making important decisions to administer, continue or discontinue medical treatment.

If someone is on life support, making the decision discontinue is often fraught with anxiety. Knowing what the person would have wanted may not make the situation less painful, but it may make it less stressful.

The Supreme Court of Canada has stated that a doctor cannot take someone off life support if family members object. What about if some family members agree to discontinue the treatment but some do not? Trying to figure out what should be done can add more tension to an already difficult situation.

An ICU stay is costly. The cost averages to about $1 million per year per patient. However, the decisions whether to continue administering life support measures are less about money and more about quality of life and of care. Most hospitals look at it as a decision between family members and health care providers. The patient's wishes indicated in any estate planning documents are a very important factor.

A proper estate plan should address many issues, including the directions about the preferrences for the end-of-life medical treatments. An estate lawyer in Ontario will be able to advise how to deal with these issues, including drafting a medical care directive.

Source: findlaw.ca, "Who has the final say in end-of-life matters?", Accessed on Feb. 10, 2018

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