Supporting you to deal with difficult questions
Osler’s ethicists have the education and training to help patients and families who are facing difficult decisions (ethical dilemmas). We can help you reflect on the situation and support you to make decisions that are in the best interests of the patient.
Patients and family members may contact our Ethics Department anytime at:
Tel: (905) 494-2120 ext. 56630
Definition: a Substitute Decision Maker is someone who has the legal authority to make decisions about treatment, placement or personal assistance services for a patient who is not able to make their own decisions.
What is capacity?
A person is presumed to be capable and is capable to make treatment, placement or personal assistance services decisions if he/she can understand the information and the consequences of making such a decision. Unless there are factors to suggest incapacity, an individual is presumed to be capable.
How is capacity assessed?
The health care provider proposing the treatment, placement, or personal assistance service determines a patient’s capacity. He/she will ask the patient questions to make sure the patient is able to understand and appreciate the risks and benefits, and alternatives in the situation.
** A patient may be capable of making some decisions but not capable of making others, like financial decisions. The patient may be capable at one time but not another time. There is no such thing as someone being incapable for all decisions, indefinitely, unless there is a situation where guardianship is involved.
Do individuals need to be informed if they are deemed incapable?
Yes, individuals must be informed. They must also be provided with information about their rights, including the right to appeal the finding of incapacity and can ask the Consent & Capacity Board for a hearing.
Medical Assistance in Dying (MAID)
As of June 2016, Medical Assistance in Dying (MAiD) is a legal option for Canadians. You may be eligible for this service if you meet the following criteria:
- Eligible for health services funded by a government of Canada
- At least 18 years of age
- Capable of making decisions about your health care
- Suffer from a serious and incurable illness, disease or disability
- Are in an advanced state of irreversible decline that is causing enduring physical or psychological suffering that is intolerable
- Natural death is reasonably foreseeable
- Give informed consent in writing
Physicians and nurse practitioners are legally authorized to provide MAiD to eligible patients. Patient who request MAiD will have their eligibility assessed by two independent physicians or nurse practitioners. The process typically takes a minimum of 10 days from the time of the request to the time at which the service is provided. MAiD can occur in the hospital or in the community.
If you have questions about MAiD or would like to request MAiD, speak with a physician or your health care team.
Additional information about MAiD can be found on the Ministry of Health and Long-Term Care’s webpage. You can also contact the Ministry of Health and Long-Term Care's Provincial MAiD Care Coordination Service, which is available for patients, caregivers, and clinicians at 1-866-286-4023 or TTY 844-953-3350. The service is available Monday to Friday 9:00 am to 5:00 pm EST, in English and French, and translation assistance in other languages can be requested. Beginning September 1, 2017, the information line will be made available 24/7. General inquiries about medical assistance in dying can be directed to firstname.lastname@example.org.
For more information about these services at Osler or within the Central West LHIN contact :
Paula Chidwick, 905-494-2120 ext 56630
Jill Oliver, 647-278-0965
Melissa Devlin, 416-747-3400 ext. 32037