Health Care Decisions Division


The Health Care Decisions Division of the Public Trustee’s Office is authorized to make decisions for a person who is not able to understand the risks, the benefits, or the consequences of an important decision about their health. The Public Trustee is the decision maker of last resort. This authority is set out In the Personal Directives Act, the Hospitals Act, and the Involuntary Psychiatric Treatment Act.

The authority of the Health Care Decisions Division is limited to making decisions about health care and home care services, and being placed in a continuing-care home. A person may have named someone to make decisions on their behalf, or have written, specific instructions about how to make decisions that respect their values, beliefs, and wishes. If not, the Public Trustee will step in only if none of these people or options is available for making a decision:

  • a guardian of the person who is appointed by the court
  • a medical care proxy who was named before April 1, 2010 under the Medical Consent Act
  • a delegate who was appointed in a Personal Directive
  • a Personal Directive that does not name a delegate but sets out clear, specific instructions or gives details about the person’s values, beliefs, and wishes about personal care decisions
  • the highest-ranked person from the list of “nearest relatives” in the list set out in the Personal Directives Act of people who can act as statutory decision makers
    1. spouse – this includes someone who is a common-law, same-sex or registered domestic partner
    2. adult child
    3. parent
    4. person standing “in loco parentis” – acting as parent
    5. adult sibling
    6. grandparent
    7. adult grandchild
    8. adult aunt or uncle
    9. adult niece or nephew
    10. other relative
    11. decision maker of last resort – the Public Trustee

A health care provider who needs to find someone to make a decision will start at the top and work down the list until they find someone who has been in contact with the person over the past year and who is willing to make the decision.

A referral can be made to the Public Trustee only after a health care provider has taken all of these steps.

Medical or Surgical Treatment in a Hospital or Psychiatric Facility

A medical professional would follow the same process for getting a decision made on a person’s behalf when the person is a patient in a hospital or psychiatric facility and is not able to make a decision about their own health care.

However, the Personal Directives Act does not replace the Public Trustee’s authority to take other actions under Hospitals Act and the Involuntary Psychiatric Treatment Act. The Public Trustee is the decision maker of last resort.

To find out how to make a referral to the Health Care Decisions Division, see