Abstract

Advance directives in Canada are instructions made by capable adults that pertain to future healthcare treatment choices at a time of incapacity. My experience as an ethicist working in an Ontario long-term care facility that provides medical treatment to patients with Alzheimer’s Dementia portrays a range of important ethical concerns that arise out of the use of advance directives, at least in terms of their current use. In this article I present a particular case and identify and analyze one of the more prominent ethical challenges that exist. My conclusion is that advance directives in Ontario do not meet the criteria for autonomous decision-making in the sense of informed consent. They may have initially been conceptualized as cohering to the standard of informed consent, but in reality, generally they do not. This point is well evidenced in the forthcoming case of Mr. Black.