Healthcare laws and regulations vary slightly by province or territory but Canadians from coast to coast generally share the following rights and options:
The right to be fully informed of all treatment options. This is also known as the right of informed consent. Your healthcare practitioner is required to inform you of the risks and benefits of each treatment option as well as the probabilities of success.
The right to recognition of a substitute decision-maker. You have the right to appoint a substitute decision-maker (SDM), someone who can represent you when you can no longer make your own medical decisions. Your SDM can speak for you with the same authority as if you were speaking for yourself.
The right to recognition of an advance care plan. Regulations vary by province or territory, but in general, healthcare providers are required to follow your wishes for treatment, provided they are appropriate to your medical condition and are clearly outlined in a valid advance care plan. Your substitute decision-maker must make the decisions you would make for yourself if you were able; this usually requires following your advance care plan.
Do Not Resuscitate (DNR) forms are legally binding in provinces or territories that offer them, so long as the documentation is filled out properly and up to date.
The right to a second opinion. It is important you feel confident with your medical decisions. Part of that confidence will come from the understanding and trust you have with your doctor.
If you feel you aren't getting all the information you need from your physician, you can seek a second opinion. All that is generally needed is a gentle query, such as "I'm having trouble deciding on the best course of action. I'm wondering if it might be possible for you to refer me for a consultation with another doctor."
While it is difficult to switch doctors, you may want to ask the consulting doctor if he or she would accept you as a permanent patient.
The right to pain and symptom management. You have the right to refuse medication, but neither the Charter of Rights and Freedoms nor healthcare legislation grants you the right to demand medication. That said, doctors want to "do no harm," and untreated pain is indisputably harmful.
Terminally ill patients can typically expect a vigorous pain management regimen, even if it may hasten the dying process.
The right to refuse treatment. You have the right to refuse any and all treatment, even if refusal might hasten your death.
The right to discontinue treatment. You have the right to stop treatment after you’ve started. Ethically and legally, there is no distinction between discontinuing treatment and refusing it in the first place.
The right to refuse food and drink. In Canada, nutrition and hydration by tube is considered medical treatment. You have the right to refuse or stop it.
You also have the right to turn down food or drink and the right to refuse to be fed or given drinks by others. This option is referred to as Voluntary Stopping of Eating and Drinking (VSED) and is supported by many palliative care providers.
The right to end your own life. It is legal to end your own life in Canada and has been since suicide was removed from the Criminal Code in 1972.
The right to request an assisted death. On Feb. 6, 2015, the Supreme Court of Canada struck down the federal ban on assisted dying, and the decision came into force on June 6, 2016. As a result, consenting adult Canadians with incurable, intolerable suffering are now legally able to end their lives with the help of a physician or nurse practitioner. For more information on Canada's medical assistance in dying law, click here.
For more information on your rights when planning for end of life, consult End of Life Planning Canada's Patients Right Booklet.