How to Update or Revoke a Health Care Directive in Manitoba

Your health care directive isn't a one-time document. Medical situations change, relationships shift, and your preferences at 45 may look very different from your preferences at 65. Manitoba law makes updating or revoking a directive straightforward — but the process of tracking down and replacing old copies is where most people run into trouble.

When to Update Your Directive

There's no legal requirement to review your directive on a schedule, but certain life events should trigger a review:

A new diagnosis. A cancer diagnosis, the early signs of dementia, or a chronic condition that changes your treatment outlook all warrant a fresh look at your directive. What you wrote when you were healthy may not reflect the decisions you'd actually make when facing a specific illness.

A change in your proxy. If your named proxy has died, become incapacitated, moved far away, or if your relationship has deteriorated, your directive needs a new name on it. A document that points to someone who can't or won't serve is functionally useless.

Divorce or separation. Under The Health Care Directives Act, if your spouse or common-law partner was authorized to sign a directive on your behalf, that authority is automatically revoked upon divorce — unless the document explicitly states otherwise. If your ex-spouse is named as your proxy, review and replace that appointment rather than assuming the divorce rule resolves it.

Admission to a personal care home. Care facilities typically ask for current planning documents during the admission process. This is a natural moment to review whether your directive still reflects your wishes, especially if your health status has changed since you last wrote it.

A significant change in values. Maybe you've had a family member go through a prolonged ICU stay and it's changed how you think about life-sustaining treatment. Maybe you've learned more about palliative care options. Whatever the reason, if your views have shifted, your directive should shift with them.

How to Update

The simplest approach is to create a new directive that explicitly revokes the old one. Include language like: "I hereby revoke any previous Health Care Directives made by me." This prevents any confusion about which document is current.

Sign and date the new directive. If you sign it yourself, no witness is needed — same as the original. The new document supersedes the old one from the moment it's executed.

How to Revoke Without Replacing

If you want to cancel your directive entirely without creating a new one, you can do so by:

• Physically destroying the original (shredding or burning)
• Creating a written revocation that clearly states your intent to cancel
• Making a clear oral or written expression of intent to revoke, as long as you have capacity

Revocation takes effect as soon as you express it. But keep in mind that if you revoke without replacing, you're leaving yourself without any documented wishes — which means clinical teams will rely on the next-of-kin hierarchy for substitute decision-making if you lose capacity.

The Critical Step Everyone Skips: Retrieving Old Copies

Revoking or replacing a directive is legally effective the moment you do it. But practically, old copies floating around create real problems. If your family physician has an outdated version in your chart and the hospital has your new one, the clinical team may end up working from the wrong document.

After updating, you need to:

1. Identify everyone who holds a copy of the old directive — proxies, family doctor, hospital registry, ERIK kit on your fridge
2. Provide each one with the updated version and confirm they've discarded the old one
3. Ask your healthcare team to mark any previous Goals of Care forms in your medical file as "NO LONGER IN EFFECT" with the date and a signature
4. Update your ERIK kit with the new document

Keep a distribution log so you know exactly who has which version. When the next update comes around, you'll know every location that needs the swap.

A Common Mistake: Partial Updates

Some people try to amend their directive by crossing out sections and writing in changes. This creates ambiguity — is the crossed-out section revoked? Was the handwritten change made while the person had capacity? Did they intend it as a formal amendment or just a note to themselves?

Don't amend. Replace. Create a clean new document with full revocation language, sign and date it, and distribute it to all the same locations that held the old one. It takes slightly more effort upfront but eliminates interpretation disputes down the road.

Keep Track of It All

The Manitoba Advance Directive & Living Will Kit includes a Document Distribution Tracker that records who has copies, which version they received, and when. When it's time to update, you'll have a clear map of every location that needs the new version — no guessing, no orphaned copies that could mislead your medical team when it matters most.

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