A photo of an ICU nurse surrounded by critical care equipment

Most patients receive some form of life support or life-sustaining treatment at the time of admission to the ICU. Life support is any treatment that supports or replaces the function of one or more of the body organs. Examples include medications to correct low blood pressure, mechanical ventilation, dialysis, or feeding through a stomach tube.

All patients admitted to the ICU are asked about their wishes regarding life support and life-sustaining treatment. If your loved one has a “power of attorney” or “living will” document, please bring in copies so that we can review them and attach them to the care chart.

When a patient is unable to tell us their wishes, we must rely on the substitute decision maker to communicate the patient’s goals, wishes, and beliefs.

Critically-ill patients often cannot speak for themselves, so we need to identify a substitute decision maker. The selection of a substitute decision maker is guided by the Health Care Consent Act. A substitute decision maker is appointed according to the following hierarchy:

  1. Power of Attorney;
  2. Spouse (married or living together in a common-law relationship for more than one year);
  3. Parent or child;
  4. Siblings; and
  5. Other relatives

A substitute decision maker must be willing, available, and capable of taking on this responsibility. If the person identified does not meet these criteria, we move down the list to identify the more appropriate substitute decision maker. If a patient does not have a power of attorney for personal care or an appropriate family member, a guardian can be appointed by the court.