Who May Give Consent?

Under review

According to the  Civil Code of Québec, the following persons may give consent to care:

  • the capable person of full age;
  • the minor 14 years of age or over may consent alone to care, whether the care is required by his state of health or not. However, parental authority is necessary for care which, while not required by his state of health, entails serious risks and may cause him serious and permanent effects (Art. 14 and 17). Certain measures also provide for the minor 14 years of age or over having to submit to the care required for his state of health and which he refuses (Art. 16);
  • the person having parental authority, in the case of a minor under 14 years of age (Art. 14). Even if the law specifies that the father and mother together exercise parental authority (Art. 600), the consent of both parents is not necessary, since each has parental authority and “where the father or the mother performs alone any act of authority concerning their child, he or she is, with regard to third persons in good faith, presumed to be acting with the consent of the other parent.” (Art. 603). In a case where the professional is informed that the parents have differing opinions, it is up to the court to decide (Art. 604). Finally, if the child is accompanied by a person other than one of his parents, the latter’s authority to give a valid consent must be verified.
  • the mandatary of an incapable person of full age and designated by the latter when he was capable, or the latter’s tutor or curator, if the care is not required.

If there is no mandatary, no tutor or no curator, and the care is required, “consent is given by the legally married or common-law spouse, or if there is no spouse or if his spouse is prevented from giving consent, it is given by a close relative or a person who shows a special interest in the person of full age.” (Art. 15).

Upon verification, you conclude that Ms. Lise T. understands the nature of her illness and the nature of the proposed surgical treatment goal; furthermore, she knows that surgery is her only chance of survival and that her refusal of the surgery will quickly lead to an inexorable prognosis. Her categorical refusal of the surgery is long-standing, dating back to well before the illness began. The psychiatric consultation you urgently requested concludes that Ms. T. shows no sign of incapacity to consent.

In the hours that follow, the patient’s health deteriorates. At one point, her state of consciousness wavers and, for an instant, she allegedly gives a sign that could be interpreted as consent to surgery. When the  psychiatric consultant returns to reassess Ms. T., she, albeit weak, reiterates her refusal of the surgery.

Ms. Lise T. dies in the evening on the day of her admission.