How to Make an Advance Directive in Nunavut

Why Nunavut Requires a Different Approach

Every other Canadian province and territory has passed legislation that lets you sign a personal directive and have it automatically recognized by hospitals and care facilities. Nunavut has not. The territory has no standalone advance directive statute, which means the document you create operates under Canadian common law rather than a territorial act.

That does not make it useless — far from it. A signed, witnessed personal directive in Nunavut serves two critical functions. First, your written treatment instructions carry weight under common law: clinicians who are aware of a capable adult's clearly expressed wishes are expected to respect them. Second, if you lose capacity and someone needs to apply to the Nunavut Court of Justice for a guardianship order under the Guardianship and Trusteeship Act, the court must give special consideration to your documented wishes and your choice of guardian.

The practical effect is that your directive becomes the single most important piece of evidence in any future guardianship hearing.

Step 1: Reflect on Your Values and Treatment Preferences

Before drafting anything, think through a few core questions:

• Do you want life-prolonging treatment under all circumstances, or would you prefer comfort-focused care if your condition becomes irreversible?
• Which specific treatments would you accept or refuse — mechanical ventilation, CPR, tube feeding, dialysis?
• Where do you want to receive care — at home in your community, at a regional health centre, or in a southern hospital?
• If you need a medevac to Ottawa, Winnipeg, or Edmonton, should your directive travel with you?

Write your answers down before opening any template. These raw notes become the foundation of your directive.

Step 2: Choose Your Proposed Guardian and Alternate

Under the Guardianship and Trusteeship Act, a guardian must:

• Be at least 18 years old
• Be a Nunavut resident
• Have had friendly, personal contact with you within the past 12 months
• Have no conflict of interest with you
• Consent to act

Name both a primary proposed guardian and an alternate in your directive. If you have no willing family member, the Public Guardian of Nunavut can step in as a decision-maker of last resort.

Step 3: Draft Your Directive

Your directive should include:

• Your full legal name, date of birth, and community of residence
• The name and contact information for your primary and alternate proposed guardians
• Your specific treatment instructions (comfort care only versus full intervention)
• Any cultural or spiritual accommodations you want — extended family vigils, traditional foods, smudging, Inuktitut interpretation
• A clear statement that you understand Canadian law does not currently permit advance requests for Medical Assistance in Dying (MAID)
• A medical travel clause specifying whether you consent to evacuation to a southern hospital and under what conditions

Avoid vague language like "no heroic measures." Clinicians need concrete instructions they can act on without interpretation.

Step 4: Sign With a Witness Present

Nunavut requires physical, wet-ink signatures. Electronic signatures and remote video witnessing are not legally valid in the territory.

Your witness must be:

• At least 18 years old
• Physically present when you sign
• Not the named proposed guardian, alternate guardian, or a spouse of either

In remote hamlets where finding an independent witness is difficult, consider a teacher, hamlet office staff member, community health representative, or a non-relative neighbour.

Both your proposed guardians should also read and sign the agreement clause confirming their willingness to act.

Step 5: Distribute and Register Copies

A directive locked in a drawer cannot protect you during an emergency. Distribute copies to:

• Your home — place a copy in a clear plastic sleeve on your refrigerator
• Your primary proposed guardian and alternate
• Your community health centre or family physician — ask them to scan it into your electronic medical record
• Your carry-on bag for every medical travel flight

Print a wallet card stating that a directive exists, naming your proposed guardian, and noting where the original is stored. Emergency responders in remote communities need to find this information fast.

Step 6: Plan for Medical Travel

Because Nunavut patients are routinely flown to Ottawa, Winnipeg, Edmonton, and Yellowknife for specialist care, your directive must be portable. Alberta, Manitoba, and the Northwest Territories generally recognize foreign personal directives if they meet local formalities. Ontario is the exception — under the Substitute Decisions Act, a Nunavut directive may not automatically grant your proposed guardian legal authority in an Ontario hospital.

Consider executing a supplemental Ontario-compliant power of attorney for personal care alongside your Nunavut directive. The Nunavut Advance Directive & Living Will Kit includes multi-jurisdictional addendums designed for exactly this situation.

Keeping Your Directive Current

Review your directive at least every three years, or immediately after any major health diagnosis. To update it, draft an entirely new document with a clause revoking all prior versions, sign it with a witness, distribute fresh copies, and physically destroy the outdated ones. An old directive floating around with contradictory instructions creates exactly the confusion you are trying to prevent.

Planning ahead takes real effort in Nunavut's paper-bound legal system, but a properly executed directive gives your family clear direction and the courts strong evidence of your intentions — two things that matter enormously when a crisis arrives.

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