Health Care Directive PEI: How to Set One Up for an Aging Parent

What a Health Care Directive Actually Does in PEI

A health care directive lets your parent name a specific person — called a "proxy" — to make medical decisions if they can no longer speak for themselves. It covers consent to treatment, refusal of treatment, and choices about procedures, medications, and palliative care.

The legal authority comes from the Consent to Treatment and Health Care Directives Act. This is separate from the newer Powers of Attorney and Personal Directives Act that governs financial and personal-care decisions. The health care directive deals strictly with medical treatment consent.

Your parent can also write specific treatment instructions directly into the directive — preferences about resuscitation, ventilation, tube feeding, or comfort-focused care. If the proxy ever faces a decision the directive doesn't address, they're expected to decide based on what the parent would have wanted.

Who Can Be a Proxy (and Who Cannot)

Any capable person who is at least 16 years old can serve as a proxy, but there's a catch most families miss: the proxy must sign the health care directive form to accept the appointment before the parent loses capacity. A proxy who hasn't signed is not legally recognized.

If someone else signs the directive on the maker's behalf, that signer and the witness cannot be the proxy or the proxy's spouse. When the maker signs personally, the Act does not require a witness.

What a Proxy Cannot Do

PEI law draws hard lines around proxy authority. A proxy is legally prohibited from consenting to:

• Medical Assistance in Dying (MAiD)
• Non-therapeutic sterilization
• Non-medically necessary medical research
• Any treatment the parent explicitly refused in their directive

These restrictions exist regardless of what the proxy believes is in the parent's best interest. If your parent has strong feelings about any end-of-life scenario, the health care directive is the place to document them — it overrides the proxy's judgment on those specific points.

What Happens Without a Health Care Directive

When there's no proxy and your parent can't consent, PEI follows a statutory priority list. The first available and willing person on this list becomes the default decision-maker:

1. Spouse or common-law partner (not separated)
2. Child (16 or older)
3. Parent
4. Sibling
5. Grandparent
6. Grandchild
7. Nephew or niece
8. Public Guardian and Trustee

The problem with this default system is that when multiple children are at the same priority level, they must agree by majority. Two siblings who disagree on a treatment plan can deadlock the process while their parent waits. Naming a single proxy in a health care directive eliminates that risk entirely.

How to Execute the Directive Properly

The directive must be written, dated, and signed by your parent. If someone else signs on the parent's behalf, the parent must acknowledge that signature in the presence of one witness, who must also sign. The signer and witness cannot be the named proxy or the proxy's spouse.

If your parent is physically unable to sign but mentally understands the document, another person can sign on their behalf — but it must happen in the parent's presence, at their verbal request, and with one eligible witness present.

Keep the original somewhere accessible (not a locked safe deposit box), and distribute copies to the named proxy, the family physician, and Health PEI if home care is already involved. Our PEI Power of Attorney & Personal Directive Kit includes the complete health care directive form alongside the financial and personal-care documents, so all three pieces of the decision-making framework are handled together.

The Health Care Directive Is Only One Piece

The directive covers medical treatment consent. It does not authorize anyone to manage your parent's bank accounts, file their taxes, sign a long-term care residency contract, or decide where they live. Those require a separate enduring power of attorney (for finances) and a personal directive (for non-medical personal matters) under the 2025 Powers of Attorney and Personal Directives Act.

Families who set up only a health care directive often discover the gap during a hospital discharge — the proxy can consent to a treatment plan but cannot sign the admissions paperwork for a long-term care facility or access the parent's income records to apply for the provincial subsidy. The complete PEI kit covers all three documents in a single coordinated package.

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