A Hearty Welcome To The Proposed 'Personal Directives Act'

Update: In an effort to add some clarity that I feel may have been sorely lacking in this post, I dug around and came across some more succint information at The Legal Information Society of Nova Scotia.

Q - Are there different types of advance health care directives?

A - There are two basic types of advance health care directives,
a proxy directive and an instructional directive.

In a proxy directive, you appoint a person as your proxy and give him or her authority to make health care decisions for you should you become unable to consent to treatment.

In an instructional directive, you set out your wishes for what health care measures you want to be taken for you should you become unable to express your wishes yourself.

You may combine both directives in your advance health care directive, or you may choose to have only one type of directive but not the other.

In Nova Scotia, the law deals only with proxy directives, under the Medical Consent Act. However, you may still provide instructions to direct or guide your proxy in making the proper health care decisions for you.

Bottom line, although "living wills", which are considered instructional directives, are not yet recognized at law in Nova Scotia (although this will likely change with the passing of the proposed Personal Directives Act) they can still be useful devices, as in most situations, I think you will find most healthcare professionals will attempt to follow your stated wishes.

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Although some Nova Scotians currently make use of 'advance care directives' or 'living wills' in an effort to appoint another person to make decisions on their behalf, give advance instructions or express their wishes on future personal care decisions, presently in Nova Scotia there is no specific legislation governing such documents. This is unfortunate, given that such documents allow individuals, while they are able, to express their personal autonomy in decisions that will affect them in the event of their incapacity.

Currently, the Powers of Attorney Act authorizes a person by execution of a Power of Attorney to authorize another person (the attorney) to manage their estate (property). A Power of Attorney is referred to as an enduring Power of Attorney if it contains a provision expressly stating that it may be exercised during the legal incapacity of the donor. However, the Powers of Attorney Act does not specifically provide for Powers of Attorney for personal care.

The only type of advance health care directive currently available in Nova Scotia is found in the Medical Consent Act. This legislation allows for a person to pre-authorize another person to give consent or direction respecting medical treatment in the event the person becomes incapable of giving consent. However, it does not provide for personal care decisions, other than medical ones, and does not provide for a person to give instructions and express their wishes about personal care decisions, including medical care.

Thus, other than medical care, there is no specific legislative authority to allow a person to appoint another person to make decisions on matters of personal care, for example, with respect to residence, care and services, and matters of comfort. Nor is there any specific legislative authority to allow a person to give advance instructions or express their wishes on future personal care decisions.

And for those who have not made an authorization pursuant to the Medical Consent Act, there is no provision in law that allows for a substitute decision maker for medical decisions for incapable persons outside of a hospital unless there is a court appointed guardian for medical care outside of a hospital.

Many stronlgy believe that other forms of advance health care directives should also be legal in Nova Scotia to better meet the needs of some people and point to the fact that advance health care directives in a variety of forms are available under laws in other provinces.

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'It's Your School'

Following are two letters from David Barrett to keep you aware of a advocacy initiative going on in the Halifax Regional Municipality. The thing is, though, I see no reason to keep this great idea limited to the Halifax Board.

What if every school board in the Province had a representative to speak on behalf of special needs students?

Hello Everyone,

Just want to update you in regards to requesting that a position be created for a representative to speak on behalf of students with special needs on the Halifax Regional School Board. Things are moving along well. The Nova Scotia Utilities and Review Board has informed me that they are unable to make a decision of this magnitude. They were also kind enough to forward our e-mails along to the Minister of Education, Karen Casey.

I have also contacted members of the Lib and NDP parties to inform them of the importance of this position if our students are to receive an education appropriate to meeting their needs. I strongly encourage you to express your views and concerns to you local MLA.

The more communication emphasizing the importance of having a Students with Special Needs Representative on the Halifax Regional School Board that crosses their
computers/desks, the better. I am asking that you work with me and contact your
MLA to educate them about this important issue.

If you didn’t have a chance to express your support for this position the first time I made this appeal, there is still time. You can send you letter via email to the
Honourable Minister Karen Casey at: EDUCMIN@gov.ns.ca .

In closing, I would like to thank all of you for supporting our children when it comes to have meaningful programming,

David Barrett , Parent Advocate.
dbarrettl@hotmail.com

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Dear Education Minister Karen Casey,

I am writing this e-mail in regards to am e-mail campaign I am presently leading. I have also made my MLA Berry Barnet aware of this campaign and who has shown his support and has agreed to speak to you in regards to this subject.

As a parent of a 14 year old special need student and a advocate for children and youth with special needs, who has worked diligently with the HRSB and government departments is regards to education of students with special needs. I find that policy and programming are not properly enforced or even in place in regards to the board it self and in order to fulfil the proper needs of all students to a successful and meaningful education there has to be changes made so that when policy and programming is designed in the HRSB that there is a representative around the table that dedicates to the issues of 20% of the HRSB's student population that are special needs.

Be it resolved that I hear by request for you, Karen Casey the Minister of Education to take a firm look at providing a seat on the HRSB and any other school board which has a special needs population of 15% or more to have a special needs representative.
There for all students within these boards would be evaluated equally when it came to programming and policies(not just the "normal" students).

Along with this I will be sending a copy of this e-mail and the letters of support to other education ministers and my MLA Barry Barnet. As of present I know that you have received approximately 35 e-mails in campaign regarding this issue, some of which were forwarded to you from the UARB board.

In closing I would like to thank you for this opportunity of making sure that our educational system provides a successful and meaningful education for all students, for this is the only goal in which will benefit the education system. I look forward to your response and I will continue correspondence with the other education ministers which I know will be questioning you in regards to this subject.

Thank-
You Parent Advocate,
David Barrett

So what we are going to do about it?



Following is a link to all of the school boards in the Province. Click on the link to your Board and let your thoughts be known. After all, if not you, than who?

Where Do You Turn?

Who do you go to if you suspect abuse of a loved one (or anyone else, for that matter) in a hospital, group home or residential care centre?

The Protection of Persons in Care Act came into force on October 1, 2007.** The legislation attempts to provide an extra safe guard from abuse for patients and residents 16 years of age and older who are receiving care in a Nova Scotia health facility (which includes hospitals, nursing homes, homes for special care or caring for persons with disabilities, group homes and residential centres) and requires health facility administrators and service providers (including staff and volunteers) to promptly report all allegations or instances of abuse.

Anyone else (that's you!) can report abuse by calling 1-800-225-7225.

You can find a few more things you need to know, such as the definition of the term "abuse" and exactly what comprises a "health care facility" here.

** Interesting side note. Although the Act was originally passed in 2004, it was not proclaimed (most Acts do not become effective until they are proclaimed) until October, 2007. Anyone else wondering what that three year delay was all about?