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Gouvernement du Québec
Régie de l’assurance maladie

Issue my directives in case of incapacity

You can decide in advance what kind of medical care you agree or refuse to have at the end of your life. Your directives, entered on a form, will be filed in a register entitled Registre des directives médicales anticipées. Health professionals are obliged to comply with your directives if your health condition renders you incapable of consenting to health care.

Conditions for stating your directives

You must be age 18 or over and able to state your directives. You will be able to do so if you can:

  • Understand the information given to you about your health condition
  • Decide what is most suitable for you
  • Communicate your wishes

How it works, in brief

You have to complete a paper form to state your medical directives. The form is then filed in the register entitled Registre des directives médicales anticipées, managed by RAMQ.

Certain health professionals are authorized to consult the register. However, they must do so only in an end-of-life situation or if your cognitive functions are severely and irreversibly impaired. This is the case, for instance, if you fall in an irreversible coma or suffer severe dementia with no prospect for improvement.

To find out more about the capacity of deciding, consent and various other considerations, refer to the webpage Advance Medical Directives at Québec.ca.

Procedure for stating your directives

  1. Download and print the form Advance Medical Directives in Case of Incapacity to Give Consent to Care or call us to obtain it.
  2. Carefully read the general information section at the beginning of the form.
  3. Complete the form, writing your initials on each page, then sign and date it. Someone else may complete the form on your behalf in your presence if you are physically unable to do so, or if you cannot read and write.
  4. Have 2 witnesses age 18 or over sign the form. The witnesses must sign after you have, and do so in your presence.
  5. Mail the form (all the pages, including the information pages) to the following address:

    Régie de l’assurance maladie du Québec
    C. P. 16000, succ. Terminus
    Québec (Québec)  G1K 9A2

Download the form online

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Contents of the form

The form allows you to accept or refuse care in 3 situations:

  • If you are suffering from a severe and incurable medical condition, in an end-of-life situation
  • If you are in a coma that is deemed irreversible or in a permanent vegetative state
  • If you are suffering from severe dementia, with no possibility of improvement (Alzheimer-type dementia or other advanced-stage dementia, for example)

For each situation, you can accept or refuse the 5 following care:

  • Cardiopulmonary resuscitation
  • Ventilator-assisted breathing or breathing assisted by another device
  • Dialysis treatment
  • Forced or artificial feeding
  • Forced or artificial hydration

Refusing this care may decrease your life duration, while accepting this care may prolong your life, but without any hope of improving your medical condition. Organ donation is always possible, regardless of these directives. Furthermore, the care necessary to ensure your comfort will always be provided to you, for instance, to alleviate your pain.

An excerpt of the form is available on the website Québec.ca.

Additional information

You can also hand the advanced medical directives form to:

  • Your physician or a health professional, so that he or she may file it in your medical record
  • A close one, who will then be able to hand it to a health professional, if you become unable to express your wishes

You must contact a notary if you wish to state your directives via a notarized act. Your notary will send us your directives so that they may be recorded in the register.

At any time, you can modify your directives, so long as you remain capable of doing so. You will have to fill out a new form Advance Medical Directives in Case of Incapacity to Give Consent to Care and send it to us. The most recent form will replace the previous one.

You can also consult your notary.

The form Revocation of Advance Medical Directives is the only way you can formally cancel your directives. You can obtain the form by calling us.

If you handed your directives to a health professional to have them entered in your medical record, you will have to send the revocation form to this health professional. If you wish to cancel the medical directives that you have kept at home, you must destroy them.

Medical aid in dying excluded

Medical aid in dying is excluded from advance medical directives. To find out more, refer to the webpage Medical aid in dying on the website Québec.ca.

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