A substitute decision-maker (SDM) is someone who is chosen to make health care decisions for a person should a severe illness or injury prevent a person from making these decisions for himself or herself. The document that grants this decision-making power to the person selected is called a representation agreement, proxy directive, or another name depending on the province or territory.
An SDM may also be called a health care representative, agent, or proxy.
Although laws vary by province or territory, a substitute decision-maker can usually make treatment decisions (if health professionals agree with these decisions) at the end of life or anytime a person can't make these decisions for himself or herself. As soon as a person selects an SDM, it is important to thoroughly discuss and document health care preferences, such as when to continue or abandon life-support measures.
Medical Review:Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Shelly R. Garone, MD - Palliative Medicine & Robin L. Fainsinger, MB, ChB, LMCC, CCFP - Palliative Medicine & Jean S. Kutner, MD, MSPH - Geriatric Medicine, Palliative Medicine