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'''Who cannot be a witness'''—the following people cannot be a witness:
'''Signing for an adult who is not physically capable'''—if an adult is not physically capable of signing an advance directive, another person can sign it for them if the adult is physically present and directs the person to sign the directive. Their signature must be witnessed as if the adult were signing the directive. The following people must not sign an advance directive for an adult:
*if, after the advance directive was made, significant changes in medical knowledge, practice, or technology have been made that might substantially benefit the adult in relation to health care.
But if you have no representative or committee of the person, your health care provider must choose a '''temporary substitute decision-maker''', or '''TSDM''', based on what the Act requires, as the next section explains.
#a person immediately related by marriage
The TSDM must be at least 19 years old, must get along be capable, and have no dispute with you, and . They must also have been in contact with you in the past 12 months.
==What kind of decisions can the temporary substitute decision-maker (TSDM) make?==
The TSDM must consult with you if possiblecan make decisions about any kind of health care, except controversial or irreversible treatments such as organ transplants and experimental surgery. If that’s not possible, [http://www.bclaws.ca/civix/document/id/complete/statreg/20_2000#section5 Section 5] of the [http://www.bclaws.ca/civix/document/id/complete/statreg/20_2000 Health Care Consent Regulation] says a TSDM can rely on what they know or reasonably believe you would have wanted when you were capable. Then they must follow your wishes and beliefs cannot consent to make those types of health care decisions in your best interest. You should let your family know now what decisions you would like if you can no longer decide for yourself.
==What if someone disagrees with a health-care decision of the TSDM?==
==Applying to court==
Under [http://www.bclaws.ca/civix/document/id/complete/statreg/96181_01#section33.4 Section 33(4) of the Act], the following people can apply to court for an order on certain things:
*a health care provider caring for an adult incapable of giving or refusing consent to health care.
*an adult's representative or personal guardian.
==More information==
To learn more about consenting to – and refusing – medical care, call the Public Guardian and Trustee of BC at 604.775.1007 in Vancouver, 604.775.1001 in the lower mainland, and 1.877.511.4111 elsewhere in BC (the call is free). Also, check the Public Guardian and Trustee website at [http://www.trustee.bc.ca www.trustee.bc.ca/ Public Guardian and Trustee website] and the Ministry of Health website at [http://www.trustee.bc.ca www.gov.bc.ca/healthMinistry of Health website].
[updated February 20142016]