Updating or Revoking an Advance Directive in Newfoundland and Labrador

Your Directive Isn't a One-Time Document

An Advance Health Care Directive (AHCD) in Newfoundland and Labrador should be a living document — reviewed regularly and updated when your circumstances change. The most common mistake people make after executing their AHCD is treating it as finished. Five years later, their medical conditions have changed, their SDM has moved away, or they've divorced the spouse they named as their healthcare proxy, and the directive no longer reflects their wishes.

The Three Legal Methods of Revocation

Under the Advance Health Care Directives Act, 1995, there are exactly three ways to revoke or change an AHCD:

1. Execute a new directive

Write and sign a completely new AHCD that explicitly states it revokes all previous directives. The new document must meet the full execution requirements: your signature, two qualifying witnesses (neither can be the SDM or the SDM's spouse), and the new SDM's written acceptance.

This is the cleanest approach. There's no ambiguity about which directive is current, and the new document stands on its own.

2. Draft a written statement of revocation

You can create a separate signed, dated written statement that revokes the existing directive. However — and this is where people get tripped up — the statement of revocation must be witnessed in the exact same manner as a directive itself. That means two independent witnesses who are not the SDM or the SDM's spouse.

A simple signed letter saying "I revoke my directive" without proper witnessing is not legally effective.

3. Physically destroy the document

Completely tearing up, burning, or shredding every original copy of the directive constitutes legal revocation. The challenge here is practical: if you've distributed copies to your physician, NL Health Services, your SDM, and placed one in your Green Sleeve, destroying only the copy in your desk drawer doesn't revoke the document. You'd need to retrieve and destroy every copy, which is often impractical.

Physical destruction is better suited as a supplementary step alongside executing a new directive rather than as a standalone revocation method.

When You Should Update

After a new medical diagnosis

A diagnosis of dementia, cancer, heart failure, or any progressive condition fundamentally changes the clinical scenarios your directive needs to address. Instructions that made sense when you were healthy may need to be more specific about the treatments you want or refuse as your condition progresses.

After a change in marital status

This one has an automatic legal consequence in Newfoundland. If you appointed your spouse as your SDM and you subsequently divorce or your marriage is declared a nullity by a court, the appointment of your spouse as SDM is automatically terminated under the Act — unless your directive explicitly states that the appointment survives divorce.

If your directive doesn't contain a divorce-survival clause, and most don't, you need to execute a new AHCD naming a different SDM immediately after your divorce is finalized. Until you do, you effectively have no appointed SDM, and the statutory default hierarchy takes over.

When your SDM can no longer serve

Your SDM may move out of province, become ill themselves, die, or simply decide they no longer want the responsibility. If the person you named can't or won't serve, your directive's SDM appointment may not work in practice. Execute a new AHCD with an alternative SDM.

After any change in your healthcare values

People's views on end-of-life care often evolve. A near-death experience, the death of a loved one, a spiritual shift, or simply aging and reflecting on what matters most can all change how you feel about resuscitation, ventilation, tube feeding, or palliative care. If your views have changed, your directive should change with them.

At least annually

Even if nothing dramatic has changed, a yearly review ensures your directive still aligns with your current medical situation, your SDM is still available and willing, and your Green Sleeve and GCD order are current. Mark a date — perhaps your birthday or New Year's — as your annual review day.

Don't Forget the Clinical Side

Updating your legal AHCD is half the job. You also need to:

1. Notify your physician and schedule a new Goals of Care conversation if your treatment preferences have changed
2. Update your GCD order to match the new directive
3. Replace the documents in your Green Sleeve — the old GCD order and AHCD come out, and the new ones go in
4. Distribute updated copies to your new SDM, NL Health Services, and anyone else who had a copy of the old directive
5. Inform the previous SDM that they're no longer appointed

An updated AHCD with an outdated GCD order in your Green Sleeve creates a dangerous mismatch — paramedics will follow the clinical order they find, not the legal document sitting in a filing cabinet.

Making Updates Straightforward

The Newfoundland and Labrador Advance Directive & Living Will Kit includes a revision protocol, a revocation template that meets the Act's witnessing requirements, and a distribution tracker so you can verify that every copy holder has the current version. Because the hardest part of updating isn't deciding what to change — it's making sure the change reaches everyone who needs to know.

See more Newfoundland and Labrador guides →