How to Make a Health Care Directive in PEI

Creating a health care directive in Prince Edward Island doesn't require a lawyer, a notary, or a filing fee. The document is free to make, and the statutory form is available from the PEI government. But the process has several requirements that are easy to miss — particularly around proxy signatures and witness rules — and a single overlooked step can invalidate the entire appointment.

Step 1: Confirm You're Eligible

PEI sets the bar at 16 years of age for a Health Care Directive, lower than the 18-year threshold for Personal Directives and Powers of Attorney. You need to be mentally capable of understanding the nature and consequences of your healthcare decisions at the time you sign. No clinical assessment is required for this — the standard is that you're acting voluntarily and comprehend what you're doing.

Step 2: Decide What Your Directive Should Cover

A PEI Health Care Directive under the Consent to Treatment and Health Care Directives Act handles two things: your treatment preferences and your proxy appointment.

Treatment preferences are where most people start. You can accept or refuse specific medical interventions, including CPR, mechanical ventilation, artificial nutrition and hydration, ICU admission, and organ donation. The strongest directives use Health PEI's Goals of Care language — R (Resuscitation), M (Medical), or C (Comfort) — rather than vague terms like "no extraordinary measures" that leave hospital staff guessing.

Proxy appointment is the other half. You name a specific person to make medical decisions on your behalf if you lose capacity. You can also name alternates in case your first-choice proxy is unavailable or unwilling to act.

Step 3: Choose Your Proxy Carefully

Your proxy must be at least 16 years old and willing to accept the role. "Willing" isn't just a verbal agreement — under PEI law, your proxy must physically sign the directive to accept the appointment. This is a hard requirement. If they don't sign, the appointment is legally invalid, regardless of what you both agreed to verbally.

Consider whether your proxy lives close enough to reach a PEI hospital during an emergency. An out-of-province proxy is legally valid, but distance creates practical barriers when a clinical team needs an immediate decision.

Disqualification rules for who can serve as a witness (if one is needed) are strict: the witness cannot be your appointed proxy or the proxy's spouse.

Step 4: Get the Form

The PEI government provides a statutory Health Care Directive template. You can also use a plain-language version that matches the statutory requirements, as long as it contains the necessary elements: your treatment instructions, your proxy's name and contact information, signature blocks for both you and your proxy, the date, and your Personal Health Number.

You are not required to use the government's specific template — any written document that meets the statutory requirements is valid.

Step 5: Sign the Directive

If you're signing the document yourself, PEI law does not require a witness. This is different from many other provinces that mandate one or two witnesses for all medical directives.

A witness is only required in one specific situation: if you are mentally capable but physically unable to sign, and you direct another person to sign on your behalf. In that case, the signer and the maker must both be physically present, and an independent witness must observe and sign as well.

Regardless of whether a witness is needed, your proxy must sign the directive separately to accept the appointment. This is the step families miss most often.

Step 6: Distribute the Document

A signed directive stored in a safe deposit box is effectively useless during a medical emergency. PEI's approach relies on proactive distribution:

• Hand-deliver a copy to your family physician or nurse practitioner. Ask them to scan it into your clinical EMR file so it's accessible across Health PEI facilities.
• Request a Goals of Care Designation discussion. Your doctor will translate your written preferences into a formal GCD medical order (R, M, or C) and save it to the provincial Electronic Medical Record.
• Give a copy to your proxy and alternates. They need the document on hand, not locked in a filing cabinet.
• Complete a Health PEI Advance Care Planning wallet card. Emergency first responders check for these.
• Keep a copy at home in a visible location — the common advice is a clear sleeve on the refrigerator.

Step 7: Tell Your Family

Even if your proxy is the only person with legal decision-making authority, informing immediate family members that the directive exists — and that it's registered clinically — prevents disputes during a crisis. If equal-ranking relatives disagree on treatment and no proxy has been appointed, the medical team must involve the Public Guardian and Trustee, adding delays and fees.

What You Don't Need

A lawyer. The directive is a self-executed document. A lawyer can help with complex family situations, but the directive itself doesn't require legal review.

Notarization. PEI health care directives don't need to be notarized.

A filing fee. There's no registration cost. The document isn't filed with any court or government registry.

A separate personal directive. Your Health Care Directive handles medical decisions. If you also want to cover non-medical personal care (housing, daily routines, social decisions), you'll need a separate Personal Directive under the Powers of Attorney and Personal Directives Act. But the healthcare document stands alone for medical purposes.

For a complete walkthrough that covers both statutes, includes pre-formatted signature blocks, and provides the Goals of Care translation worksheet used by Health PEI clinical staff, see the Prince Edward Island Advance Directive & Living Will Kit.

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