Advance Care Planning in Quebec: Understanding Protection Mandates and Advance Medical Directives

Quebec's unique civil law system creates distinct approaches to advance care planning. The province offers two main tools: Protection Mandates (formerly called Mandates in Case of Incapacity) and Advance Medical Directives. Understanding both helps ensure your wishes are respected.

Quebec's Distinct Approach

Unlike other provinces, Quebec's system reflects its civil law tradition. This creates important differences in how advance care planning works:

Protection Mandates:

• More comprehensive than other provinces' powers of attorney
• Must be notarized or witnessed
• Require court validation when needed
• Cover both personal care and property
• Include healthcare decisions

Advance Medical Directives:

• Legally binding on healthcare providers
• Limited to specific medical situations
• Registered with the province
• Cannot be overridden by family
• Take precedence over mandates for covered treatments

Choosing Your Tools

Protection Mandate

Think of this as your master plan. It allows you to name someone (your mandatary) to make decisions about:

• Healthcare
• Housing
• Personal care
• Lifestyle choices
• Financial matters

Advance Medical Directives

These focus specifically on end-of-life care and cover five specific situations:

• End-stage medical conditions
• Severe, irreversible brain damage
• Dementia in its advanced stages
• Other irreversible coma or unconscious states
• Other situations as defined by regulation

Creating Valid Documents

Protection Mandate Requirements

Two creation methods exist:

Notarial Form:

• Prepared by notary
• Officially registered
• Provides legal guidance
• Ensures validity
• Creates official record

Witnessed Form:

• Written by you
• Requires two witnesses
• Less expensive
• More flexible
• Still legally valid

Advance Medical Directives

Can be created through:

• Official form from RAMQ
• Notarial deed
• Online through Quebec Health Portal
• Healthcare institution forms

Choosing Your Mandatary

Your mandatary (decision maker) should be:

• Trustworthy and reliable
• Familiar with your values
• Available when needed
• Good at communication
• Comfortable with responsibility
• Capable of difficult decisions
• Respectful of your wishes

Important Considerations

Language Matters

Quebec requires:

• Documents in French or English
• Clear expression of wishes
• Precise terminology
• Specific instructions
• Proper legal form

Healthcare System Integration

Quebec's healthcare system will:

• Check the directives registry
• Honor registered wishes
• Consult mandataries
• Follow legal requirements
• Respect cultural preferences

Making Changes

You can modify your:

Protection Mandate:

• Through new notarial deed
• With new witnessed document
• While mentally capable
• Before court validation

Advance Medical Directives:

• Through new registration
• By revoking old ones
• Using official forms
• Via healthcare provider

Starting the Process

1. Consider Your Options:

• Protection Mandate
• Advance Medical Directives
• Both documents
• Additional planning needs

2. Consult Professionals:

• Notary
• Healthcare provider
• Legal advisor
• Family members
• Social workers

3. Document Your Wishes:

• Choose creation method
• Complete forms
• Register documents
• Inform key people
• Store safely

Cultural and Religious Considerations

Quebec's diverse population means considering:

• Religious practices
• Cultural traditions
• Language preferences
• Family structures
• Community values

Resources and Support

Government Resources

• Régie de l'assurance maladie du Québec (RAMQ)
• Curateur public du Québec
• Ministry of Health and Social Services
• Quebec Health Portal
• Local health institutions

Professional Support

• Chambre des notaires
• Healthcare providers
• Social services
• Community organizations
• Senior advocacy groups

Common Questions

"When does a Protection Mandate take effect?"
Only after court validation when incapacity is determined.

"Can family override my Advance Medical Directives?"
No, these are legally binding on healthcare providers.

"Do I need both documents?"
They serve different purposes; having both provides comprehensive coverage.

Quebec's unique approach to advance care planning offers strong protections for your wishes. While the system might seem complex, it provides clear frameworks for ensuring your healthcare and personal care preferences are respected.

Remember:

• Consider both available tools
• Follow proper creation procedures
• Choose mandataries carefully
• Register documents appropriately
• Keep information current
• Inform key people

Need help? Consult a notary or healthcare provider to understand your options and create documents that best protect your interests.