Being moved to a different unit
While we will do our best to meet your needs and preferences, you may be moved to a different area of the hospital to ensure you receive the best care possible, or if another patient is in great need of care in that particular area. If you or your family have questions about being moved to a different unit, please ask a member of your health-care team.
When you are moving, the health-care teams will communicate with each other regarding your care needs and treatment goals. You and your family are encouraged to ask as many questions as needed in order to feel comfortable with your care.
We appreciate your understanding when these situations arise.
Emergency and life sustaining treatments
Understanding your wishes and our practice
To ensure we are best supporting patient preferences, on admission every patient has a conversation about medical emergencies to plan for how the health care team will respond. You have the right to refuse resuscitation, just like any other treatment, and you can set limits on when it would or would not be used. You may change your decision at any time. If you have specific wishes or concerns, please talk with your care team and your Substitute Decision-Maker, and share your values and goals so your treatment plan reflects what matters most. If you decide resuscitation is not right for you, we will still provide all other clinically appropriate care unless you tell us otherwise.
Please ask a member of the health-care team for more information or consider Clinical Ethics consultation.
Substitute Decision-Maker (SDM)
A Substitute Decision Maker (SDM) is responsible for making decisions for someone who is unable to make them for themselves. The SDM is required to make decisions that are in accordance with the patient’s previous wishes or in their best interest.
Who can make healthcare decisions?
In Ontario, every person has the right to make their own healthcare and treatment decisions when they are capable. If a patient is deemed incapable of making decisions, an SDM will decide on their behalf. The highest ranking person or persons on this list is the legal SDM:
- Court Appointed Guardian
- Attorney for Personal Care (POA)
- Representative appointed by the Consent and Capacity Board (CCB)
- Spouse or partner
- Parents or Children
- Siblings
- Any other relative
- Public Guardian and Trustee (PGT)
A copy of the document for Guardianship, POA, or CCB appointing an SDM must be provided to the medical team.
How should treatment decisions be made?
There are laws that SDMs must follow when making treatment decisions for someone else. As an SDM, you are not being asked to make the decision you think is best. The law requires that you make treatment decisions consistent with the patient’s prior capable wishes, or if these wishes are unknown, that are in the patient’s best interests.
What are prior capable wishes and best interests?
A capable person can express their wishes for future treatments, verbally or in writing. The most recent wishes expressed by the patient should guide the SDM’s decisions. For example, if a patient previously wanted everything done to stay alive but later said they just want to be kept comfortable, the most recent wish should take priority. If the SDM is unaware of the patient’s wishes or if impossible to follow, the SDM must make decisions based on the patient's best interests. This includes considering the patient’s known values and beliefs, and the treatments that would improve their condition.
Frequently Asked Questions
As an SDM, you are required by law to make treatment decisions based on the patient’s prior capable wishes, not on what you believe is best. The law requires that you make treatment decisions consistent with the patient’s prior capable wishes, or if these wishes are unknown, that are in the patient’s best interests.
How should I make decisions about my loved one’s healthcare?
As an SDM, you must make decisions that are in accordance with the patient’s prior expressed wishes or in their best interest.
How might I know what my loved one’s wishes are?
Prior wishes may be written (e.g., power of attorney for personal care, advance directive or living will, or other), or may have been expressed to you verbally while they were still capable.
What if I don’t know of any prior wishes?
If you are unaware of prior wishes, you must decide based on the patient’s best interests. “Best interests” are determined by considering the values and beliefs the patient held while capable, as well as the treatments that will improve the patient’s condition. You may also consider any current wishes the patient has expressed while unable to make decisions.
Another relative and myself are both SDMs, what happens if we cannot agree on a treatment?
If there is a disagreement about treatment decisions, a group meeting with your physician might be helpful, however we cannot make treatment decisions for you. If a disagreement cannot be resolved, a public official from The Public Guardian and Trustee will make the decision, or the Consent and Capacity Board may appoint a representative.
What if I don’t want to be the SDM?
It can be very difficult for you to take on the responsibility of making medical decisions on behalf of your loved one. If you do not want to make these decisions, then you can withdraw from the position of SDM and the next person in the hierarchy would be contacted to make decisions. You cannot choose who is the next SDM.
Lab Test Reporting
London Health Sciences Centre has joined the Ontario Laboratory Information System (OLIS).
OLIS is a secure information system that allows health care providers (hospitals, community laboratories, public health laboratories and practitioner) to instantly and securely share lab results.
There are many benefits to patients:
- Timely and complete lab information will improve care
- Less duplication of lab tests
- Fewer gaps in patient information as the patient moves between hospital, family physician, and long-term care home, for example
- Reduced lab result wait times
At this time more than 40 laboratory groups, in Ontario, including hospitals and private labs are sending their data to OLIS. OLIS is a component of the Ministry of Health and Long-Term Care’s eHealth Strategy and the creation of an electronic health record for Ontarians.
London Health Sciences Centre is very serious about ensuring the privacy and security of your personal health care information. If you wish to restrict access to your information on OLIS, please contact Service Ontario at 1-800-291-1405 (TTY 1-800-387-5559).
Access Your Health Information with MyCarePortal
MyCarePortal is an accessible, free, and secure online portal that allows patients to access their personal health information documented in our OneChart system. To register, patients aged 16 and older can visit the MyCarePortal website and complete the online enrollment process.
