Help With Difficult Descisions

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

Substitute Decision Makers (SDM)

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.

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