Dr. Louise Chartrand, University of Manitoba, Winnipeg, MB

The 1996 Health Care Consent Act of Ontario (Canada) is a law that regulates medical decision making. Therefore, it also gives indications on how end of life decisions should be made. The goal of the law was to ensure and protect patient’s autonomy and avoid medical paternalism, especially at the end of life. This presentation would like to argue that one of the consequences of the 1996 Health Care Consent Act of Ontario is to promote individualism. Therefore, this law makes it improbable to attain a shared decision model. More specifically, the way the 1996 Health Care Consent Act is currently written, a proxy is assigned as a decision-maker for someone who is deemed incompetent. However, it also ensures that the proxy will be the only one with the burden of that decision. This argument will be supported by providing a qualitative description of three cases encountered during Dr. Chartrand’s six-month fieldwork in the Intensive Care Unit (ICU) of a hospital located in Ontario. The presentation will offer a reflection upon the consequences of using an alternative decision maker (proxy) to withdraw life support.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • establish the difference between individualism and autonomy;
  • establish the difference between individual and shared decision making; and
  • propose new ways to improve decision making in regards to withdrawing life support.