HomeLearnPlanning GuidesWhat is a Health Care Directive in Ontario and Do You Need One?
Planning Guides7 min read·Updated May 2026

What is a Health Care Directive in Ontario and Do You Need One?

The Power of Attorney for Personal Care appoints the person who will make health-care decisions for you if you cannot. The Health Care Directive tells that person exactly what decisions to make. Under Ontario's Health Care Consent Act, 1996, both documents work together — the POA gives your attorney legal authority, and the Directive gives them binding guidance on the choices that matter most: CPR, artificial nutrition, mechanical ventilation, palliative care, organ donation. This guide explains what a Health Care Directive is in Ontario, how it differs from a POA for Personal Care, and why Willbeing includes it free with every POA for Personal Care.

Canada Notary Legal Team
Published May 2026 · Reviewed by qualified notaries

What a Health Care Directive is

A Health Care Directive — also called an 'advance directive' or 'living will' in common parlance — is a written statement of your wishes about medical treatment, prepared while you have decision-making capacity, to be applied if you later lose that capacity. In Ontario, it is not a stand-alone statutory instrument (the way a will or POA is); it is a companion document to your Continuing Power of Attorney for Personal Care, and it derives its force from the <em>Health Care Consent Act, 1996</em>, S.O. 1996, c. 2, Sch. A.

Section 21 of the Health Care Consent Act says that a substitute decision-maker (which includes your Attorney for Personal Care) must give effect to any wish the incapable person expressed while capable, if the wish is applicable in the circumstances and can be complied with. That's the legal engine that makes a written Health Care Directive binding.

How a Directive differs from a POA for Personal Care

The two documents solve different problems. A POA for Personal Care <strong>appoints</strong> a person and grants them legal authority to make decisions on your behalf. A Health Care Directive <strong>instructs</strong> that person on what decisions to make. Neither replaces the other.

Without a POA for Personal Care, your written wishes cannot be actioned by the person you would have chosen — hospital staff must fall back to the statutory hierarchy of substitute decision-makers in section 20 of the HCCA (spouse, then child, then parent, and so on). Without a Health Care Directive, your Attorney for Personal Care must guess at your wishes on the hardest calls — do you want to be resuscitated? Do you want a feeding tube in an end-stage condition? Do you want palliative sedation?

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Short version
POA = who decides. Directive = what they decide. You need both. That's why every Willbeing POA for Personal Care comes with a Health Care Directive included at no extra cost.

Why you need both — the appointment vs the instruction

Consider the scenario: you have a serious stroke, are unconscious, and the treating team needs to decide whether to place you on a ventilator. If you have only a POA, your attorney has legal authority but is being asked to make one of the most consequential decisions of your life without knowing what you actually wanted. Family disagreements over these decisions are among the most painful and public conflicts that reach Ontario courts.

If you have only a Directive but no POA, the treating team follows the section 20 HCCA hierarchy — which may or may not be the person you would have chosen. A Directive without a POA is like a set of instructions without a named recipient.

With both documents in hand, your attorney can point to your written wishes and say, 'These are her instructions. This is what she wanted.' The treating team has legal cover to act. Your family has clarity. You get the care you would have chosen for yourself.

What a Health Care Directive covers

A well-drafted Ontario Health Care Directive addresses the specific decisions that a substitute decision-maker will otherwise have to make blind. The Willbeing directive uses a seven-section structure that mirrors the Canada Notary precedent used by Ontario's estate-law community:

  • <strong>Purpose</strong> — that this Directive is intended to be given effect under section 21 of the Health Care Consent Act, 1996, and to be read together with your POA for Personal Care.
  • <strong>Attorney for Personal Care</strong> — a cross-reference to your POA of even date, confirming the appointment and the alternate.
  • <strong>Life-sustaining treatment</strong> — your general approach (comfort-focused vs life-extending vs trial-of-treatment), CPR / DNR preference (with reference to the Ministry of Health DNR Confirmation Form), mechanical ventilation, artificial nutrition and hydration, antibiotics in an end-stage condition.
  • <strong>Comfort and palliative care</strong> — aggressive symptom management even where medication may shorten life, consent to palliative sedation, presence of spiritual advisors and family.
  • <strong>Personal care wishes</strong> — preferred place of care (home / hospital / hospice / long-term care), dignity, cultural and religious values, presence of loved ones.
  • <strong>Mental health care</strong> — cross-reference to the <em>Mental Health Act</em>, R.S.O. 1990, c. M.7, authorizing your attorney to consent to psychiatric assessment and treatment where applicable.
  • <strong>General provisions</strong> — organ and tissue donation under the <em>Trillium Gift of Life Network Act</em>, R.S.O. 1990, c. H.20; revocation; governing law; severability; the priority of the POA for Personal Care as the legally operative instrument.

How it works in practice under Ontario law

When you become incapable of making a health-care decision, your treating physician proposes a course of treatment and asks for consent. Under section 10 of the HCCA, they must ask the substitute decision-maker at the top of the section 20 hierarchy — which, if you have a valid POA for Personal Care, is your named attorney.

Your attorney then applies section 21 of the HCCA — they must give effect to any wish you expressed while capable, if the wish is applicable in the circumstances. Your written Directive is the clearest possible evidence of those wishes. A physician who receives a written Health Care Directive from a valid Attorney for Personal Care is on very solid legal ground when they act on it.

In Ontario, an oral wish expressed while capable is technically binding under section 21, but oral wishes are hard to prove, disputed by other family members, and often not remembered accurately in a crisis. Written directives are the standard of care.

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What the Directive does not do
A Health Care Directive does not authorize medical assistance in dying (MAID) — MAID has its own written request process under the Criminal Code, and a person must be capable at the time the assessment and reflection period conclude. The Directive also does not override the treating physician's clinical judgment where the requested action would be outside the standard of care.

Why Willbeing includes it free with POA for Personal Care

Most Canadian online will platforms sell the Directive as a separate $40–$60 add-on. Many law firms include it inside the retainer for their POA package but charge a bundled fee. Standalone, Willbeing prices the Health Care Directive at $49.99 — but if you also purchase a POA for Personal Care, we include it free.

The reason is simple: the two documents are not meaningfully separable. A POA for Personal Care without a Directive is half-built, and a Directive without a POA cannot be actioned by the person you would have chosen. We include the Directive because leaving it out would produce a substandard product for the client. It costs us nothing to auto-generate the Directive from the questionnaire data you have already given us; it costs you nothing at checkout.

Every Willbeing POA for Personal Care order automatically produces two documents at execution: the POA and the Directive. They are stored together in your Willbeing account and printed as a set for your Canada Notary appointment.

How to create yours

Start a POA for Personal Care order in the Willbeing wizard. The questionnaire captures both the appointment (your attorney, alternate, revocation conditions) and the treatment preferences that populate the Directive (CPR, artificial nutrition, palliative approach, organ donation, preferred place of care). One questionnaire, two documents, no extra charge.

You can also add POA for Personal Care to an existing Willbeing order at any time — the Directive comes with it automatically. If you have already purchased a Will + Both POAs bundle, your Directive is already in your account under your POA for Personal Care.

Get the Directive free — with your POA for Personal Care.
Every Willbeing POA for Personal Care order includes a fully drafted Health Care Directive at no extra charge. Same appointment, same witnesses, same day.
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In this article
1What a Health Care Directive is
2How a Directive differs from a POA for Personal Care
3Why you need both — the appointment vs the instruction
4What a Health Care Directive covers
5How it works in practice under Ontario law
6Why Willbeing includes it free with POA for Personal Care
7How to create yours
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