How to Make a Living Will in Ontario: Step-by-Step Process

Start With the Right Document

If you are trying to make a living will in Ontario, the first thing to understand is that the province does not use living wills as standalone legal instruments. Ontario's Health Care Consent Act requires that consent to medical treatment come from a living person, not a document. Your healthcare wishes need to be embedded in a Power of Attorney for Personal Care (POA-PC) under the Substitute Decisions Act — and the process of creating one is straightforward, even without a lawyer.

Step 1: Decide Who Should Speak for You

Before you write a single word of treatment preferences, choose the person who will make decisions on your behalf when you cannot. This is the most consequential decision in the entire process.

Your attorney must be at least 16 years old and mentally capable. They cannot be someone who provides you with health care, residential, social, training, or support services for compensation — unless they are also your spouse, partner, or relative. You can appoint more than one attorney to act jointly (all must agree) or jointly and severally (any one can act alone), but joint appointments create a consensus requirement that can deadlock during a crisis.

Think about who will actually follow your wishes, even under pressure. The hospital may push for aggressive treatment. Other family members may disagree. Your attorney needs the emotional resilience to stand firm and the practical availability to be reached on short notice.

Step 2: Document Your Treatment Preferences

This is the part that functions like a living will. Write specific instructions about the treatments you want or do not want in various clinical scenarios:

• CPR and resuscitation during a terminal illness versus a sudden reversible event
• Mechanical ventilation as a short-term bridge versus indefinite life support
• Artificial nutrition and hydration during active dying
• Palliative sedation when other symptom management has failed
• Organ and tissue donation preferences

Generic statements like "no extraordinary measures" give your attorney almost nothing to work with. Physicians routinely set aside vague instructions because they cannot be meaningfully applied to the specific clinical decision at hand. State what you want, in what circumstances, and explain the reasoning behind each preference so your attorney can extrapolate to situations you did not anticipate.

Step 3: Execute the Document With Two Eligible Witnesses

Ontario has strict witnessing requirements. You need two adult witnesses who are physically present when you sign — or connected through real-time audio-visual technology if using virtual signing.

The following people are legally prohibited from witnessing your POA-PC: the person you are appointing as attorney; the attorney's spouse or partner; your own spouse or partner; your children; and anyone under guardianship.

For in-person signing, both witnesses watch you sign and date the document, then sign and date it themselves. For virtual signing under the SDA's permanent provisions, at least one of the two witnesses must be a licensee of the Law Society of Ontario — a lawyer or paralegal. All parties sign their own counterpart copies simultaneously during the same video call.

Although the SDA does not require it, having at least one witness swear an Affidavit of Execution (Form 74.8) before a Commissioner for Taking Affidavits is strongly recommended. This prevents future validity challenges, particularly if the POA-PC is ever questioned by a healthcare provider or financial institution.

Step 4: Distribute Copies and Store the Original

Your attorney needs a copy. Your family physician should have a copy. If you use a specialist or have a palliative care team, they should have copies as well. The original should be stored somewhere your attorney can access quickly — not in a safety deposit box that is sealed during evenings and weekends.

If you anticipate needing the DNR Confirmation Form (the only document that directs paramedics in an emergency), have that conversation with your physician now. The DNR-C is a separate clinical form that your doctor must sign; it cannot be included in the POA-PC.

Step 5: Also Execute a Continuing Power of Attorney for Property

The POA-PC covers healthcare decisions. Your finances — bank accounts, investments, property taxes, mortgage payments — require a completely separate Continuing Power of Attorney for Property. Without it, your family faces a guardianship application that costs $10,000 to $15,000 and can take a year. Both documents use the same two-witness execution requirements.

What You Can Do Without a Lawyer

The Substitute Decisions Act explicitly allows any capable person age 16 or older to create a POA-PC without legal counsel. The OPGT provides free blank statutory forms. What you are paying a lawyer for — if you hire one — is the guidance on structuring treatment instructions, navigating witnessing requirements, and anticipating problems like bank rejections or sibling disputes.

Our Ontario Advance Directive & Living Will Kit provides that same guidance at a fraction of the cost: treatment preference worksheets, witnessing checklists for both in-person and Bill 245 virtual execution, document storage protocols, and attorney conversation scripts to ensure the person you appoint is prepared for the decisions they will face.

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