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(1) (a) i) a)0..0..0..0..0..0..  23  0..j @6Outline[8]I. A. 1. a. (1) (a) i) a)0..0..0..0..0..0..0..  23  0..(6 Z 6Times New Roman Regular %(\  p`&Times New Roman  ' +% %  +  CEUS.,  ݛ?' xdEx?(w2$ C! +% %  +  CEUS.,   ) +% %  +  CEUS.,  ݛhh`"`"e(#     1  (w2$ C! +% %  +  CEUS.,  2c0Quick &&0 (w2$ C! +% %  +  CEUS.,   d'dxd Level 1 Level 2 Level 3 Level 4 Level 5(w2$ C! +% %  +  CEUS.,  ($     (w2$ C! +% %  +  CEUS.,  E<< c j " +% %& +  CEUS.,  ݛo[h hp x (#%'0*,.8135@8:<H?ACPFHKXMXo  &֚&X'&֚ Childrenand  advancedirectives +4  p0Times New Roman Bold%\  `$Times NewRoman  )'+% %. +  CEUS.,  ݛ. o[h hp x (#%'0*,.8135@8:<H?ACPFHKXMXo{[X` hp x (#%'0*,.8135@8:<H?Ah XpX{.  !!!(#.   23   " +% %R +  CEUS.,  ݛS?cR  S'S?c Consultationwith  Albertans  " +% %  +  CEUS.,  ݛ   !    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Restrictionson  proxysauthority  H " +% %U +  CEUS.,  ݛo[h hp x (#%'0*,.8135@8:<H?ACPFHKXMXo  U֚UY'U֚ Actingasaproxy (\  p`&Times New Roman " +% %j +  CEUS.,  ݛj֚jk'j֚  Whatthe  legislationwillnotdo+4  p0Times New Roman Bold(\  p`&Times New Roman " +% %  +  CEUS.,  ݛ   !    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Changingor  cancellinganadvancedirective (\  p`&Times New Roman+4  p0Times New Roman Bold(\  p`&Times New Roman+4  p0Times New Roman Bold " +% %  +  CEUS.,  ݛ    !   Needfor  guardianship  ` " +% % +  CEUS.,  ݛo[h hp x (#%'0*,.8135@8:<H?ACPFHKXMXo  ?c  u !?cAppealstothe  Courts (\  p`&Times New Roman+4  p0Times New Roman Bold C! +% %  +  CEUS.,  ݛ ( h XX-iRB>zx}` p @ Pdddd@E}` Xdd ?' 7)dEX+?    V Allofusarefacedwithdailydecisionsabout  whattoeat,wheretolive,whattodoifwegetsick,andmanyotherdecisionsaboutourownhealthandrelatedpersonalcare.Butwhathappenswhenwecannolongermakethesedecisionsforourselves?Thisisnotaquestionmanyofuswanttoaskletaloneanswer.Butplanningforthispossibilitymaybeoneofthemostimportantthingswecandoforourselvesandourfamilies.TheGovernmentofAlbertaisproposingnewlegislationthatwillsupportAlbertansinplanningforapossiblefuturelTD@zx` p @dddd@E` Xdd- wheretheindividualcannotmakehisorherowndecisions. V ThisnewlegislationwillincreasetheautonomyandselfdeterminationofindividualAlbertanswhowanttotakegreatercontrolofdecisionsaffectingtheirfuturehealthandrelatedpersonalcare,shouldthetimeevercomewhentheyarenotcapableofmakingthose  f $2<#d_dddecisionsthemselves.TheproposedAdvance$<2JԀDirectives#ddd_\ l Actwillallowindividualstodirectthedecisionsthat r willneedtobemadeabouttheirownhealthandpersonalcareinadvanceofthetimethatthosedecisionsarerequired.Thisactwilldothreemainthings:,0 V Recognizetherightofindividualstomakean < informedchoiceabouthealthandrelatedpersonalcarenowandinthefuture. V(#V(# ,0 V Make"livingwills"legallybindingT"V(#V(# ,0 V Protectthosewhoarementallyincapableof `$ makingtheirowndecisionsbyensuringthatsomeoneelsecanbenamedtomakedecisionsonbehalfofthementallyincapableperson. V(#V(#  V Peoplewhomaywanttotakeadvantageofthisnewabilitytodecidewhatkindofhealthandrelatedpersonalcaretheywantduringapossiblefutureperiodofincapacitycouldinclude:?' 7)dEX+?,0 V Anindividualdiagnosedwithaterminalillness.))V(#V(# Ї,0 V Anindividualwithaprogressivedementia,like  Alzheimerdisease V(#V(# ,0 V #d_ddAnindividualabouttoundergocomplexsurgery#ddd_ V(#V(# ,0 V Anindividualwitharecurringcondition,such   ascertaintypesofmentaldisorders,whichleavesthemincapableofgivinganinformedconsentfortreatmentatcertaintimes V(#V(# ,0 V Anindividualwhowantstomakesurethat,in <  theeventofaseriousaccident,thenecessaryhealthandrelatedpersonalcaredecisionsreflecttheirwishes V(#V(# ,0 V Anindividualwithstrongconvictionsregarding Z treatmentsthatarenotdesiredunderanycircumstances,suchasbloodtransfusions. V(#V(# ,0 V Anyindividualwhowantstoplanforapossible r futureincapacity V(#V(# NTD@zx` p @dddd@E` dd! ( V ?' 7)dEX+?Theproposedlegislationisdesignedtobeenablingandsupportiveofindividualresponsibilityforone'sownhealthandrelatedpersonalcare.UnderstandingwhatthelegislationwillNOTdoisalsoimportant.,0 V Itisnotasteptoward"righttodie"legislationN!V(#V(# ,0 V ItdoesnotsupporteuthanasiaZ#V(#V(# ,0 V Itdoesnotsupportrequestsforillegal f%  procedures,suchasalethalinjection V(#V(#  V Forthesereasonsandothers,itmaynotalwaysbepossibletocarryoutanindividual'swishesaboutfuturehealthandrelatedpersonalcare.Forexample,adesiretohaveacertainprocedure,suchasaheartlungtransplant,wouldnotbindahealthpractitionertoproposesuchtreatment.Similarly,anydecisionwhichrequiredtheagreementofanotherperson,suchasa .)) desiretoliveonlywithone'sdaughter,maynotbepossible. V ThecurrentAlbertaPowersofAttorneyAct  allowsyoutonamesomeonetotakecareofyourfinancialaffairsifyoubecomementallyincapableofmakingyourownfinancialdecisions.TheGovernmentofAlbertaisplanningtointroducelegislationinthespringof1995tomakesurethatyouwillalsobeabletonamesomeonetomakedecisionsaboutyourhealthandrelatedpersonalcareortowritedowninstructionsforsuchdecisionsifyoubecomeunabletomaketheseimportantchoicesforyourself.WGCz|o` . p @dddd@Eo` Xdd ?' 7)dEX+? V TheGovernmentwantstoknowwhatyouthinkaboutthevariouspartsofthisproposednewlaw.Since1991,therehasbeenalotofdiscussionwithdoctors,lawyers,governmentofficials,andotherprofessionalpeoplewhoworkinthehealthandrelatedpersonalcarefield.Manygroupsandorganizationshavealsobeenconsulted. V In1993,theAlbertaLawReformInstituteandtheHealthLawInstitutedraftedproposedlegislationwhichwasoneofthestartingpointsfortheGovernmentinconsideringwhatmightbeincludedinthenewlegislation.Someotherprovinces,includingBritishColumbia,Manitoba,Ontario,NovaScotia,andNewBrunswick,have?' 7)dEX+?beenconsultedandsomearenowpreparingorimplementinglegislationtoensurethatindividualscannameanotherpersontomakehealthandrelatedpersonalcaredecisionsforthemiftheyshouldbecomementallyincapable.Now,itistimetofindoutwhattypeoflegislationAlbertanswant. V Thisdocumentisdesignedtoexplainthekeyissuesinvolvedindevelopingthislegislationandtohelpyouinmakingupyourmindonsomeoftheimportantissues.Responsesheetsareprovidedattheendofthisbookletforyoutousetoanswersomeofthequestionscontainedinthisdocument.Youmay .)) wanttowritetotheMinisterofHealthwithamorecompleteresponsetotheissuesidentifiedhere,ortalktoyourM.L.A.abouttheissues.Broaddiscussionoftheconceptswithyourfamilyandfriendswillhelpyoutodecidewhatthebestoptionsmightbe.YourviewsareimportantinensuringthatthisproposednewlegislationmeetstheneedsofallAlbertans. TD@zx= ` p @dddd@E= ` Xddu  V ManyAlbertansexpectthatcloserelativeswillhavetherighttomakehealthandrelatedpersonalcaredecisionsforthemiftheycan'tmakethesedecisionsforthemselves.ThisisnotthecaseinAlberta.Relatives,suchaswivesorhusbands,oradultchildrenactuallyhavenorealauthoritytotelladoctororotherhealthcarepractitionerwhattreatmenttoperformornottoperform.Althoughdoctorsusuallyasktheclosestrelativetoconsenttomedicaltreatment,thedoctorisundernorequirementtofollowthatdecision,butcanfollowtheirownclinicaljudgementinstead. V Eventhedoctorsareatriskinmakingthesedecisionsforsomeoneelse.Doctorssometimeshavetowalkafinelinebetweenbeingaccusedofmalpracticeiftheytreatapatientinawayinconsistentwiththatperson'swishesorwiththefamily'swishes,andbeingsuedfornegligencefornotprovidingtreatmentatall.Incasesofemergency,doctorsaresupportedbythecurrentcommonlawtodoeverythingpossibletosaveaperson'slife,evenifthatisnotwhatthepersonwouldhavechoseniftheyhadbeenabletomakethedecision. V Manypeoplewanttohavecontrolovercriticaldecisionsthatmaybemadea?' 7)dEX+?boutthemiftheybecomementallyincapableofmakingthosedecisionsthemselves.  Doyouagreethatyourcontroloverhealthand +&& relatedpersonalcaredecisionsaffectingyou#dZddshouldbestrengthenedbypassingnewlegislation? #dddZ $ -((    .)) Їf!2"`xu` `E` \dd f V Therearethreemajorcomponentsintheproposedlegislation:,0 V Individualswillbeabletowritedown  instructionsformedicaltreatmentandotherhealthrelatedpersonalcareforthefutureiftheybecomeincapacitated.Thesewrittendocumentsarecalled"advancedirectives"or"livingwills". V(#V(# ?' 7)dEX+?,0 V Individualswillbeabletonamesomeoneelse, <  calledaproxy,tomakehealthandrelatedpersonalcaredecisionsforthemiftheyareunabletomakethosedecisionsthemselves. V(#V(# ,0 V Ifanindividualhasnotwrittendownany Z instructions,andhasnotnamedsomeoneelsetomakedecisionsforthem,thentheproposedlawwouldrequirethattheindividualsclosestavailablefamilymemberbeaskedbythedoctoriftheyarewillingtomakehealthandrelatedpersonalcaredecisionsfortheindividual. V(#V(#  V Appointingaproxyhelpstomakesurethatifyourinstructionsarenotclear,orifyouhaven'tconsideredeverypossiblecircumstanceortreatmentoption,yourproxycaninterpretyourwritten#d_ddinstructionsandmakethedecisionthatyouwouldhave H  made#ddd_*Ԁforthedoctororotherhealthcarepractitioner. N!  V Ifyouhaven'tnamedaproxy,andadecisionmustbemadeaboutyourmedicaltreatmentorotherhealthrelatedpersonalcare,thelistoffamilymemberswouldhelpthehealthcarepractitionerlocateyourclosestrelativetomakethedecisionforyoutoensurethatyourwishesarefollowed.  Doyouthinkthatallthreecomponentsshould *%% beincludedinthenewlegislation?  +&&    .)) "TD@zx` p @dddd@E` dd@  V Thisnewlegislationwillbebasedonanumberofunderlyingprinciples.Anynewprocessformakingdecisionsnowaboutyourowncareinthefutureshouldhavethefollowingfeatures:o[h hp x (#%'0*,.8135@8:<H?ACPFHKXMh Xo EqualAccess 0 p AnyAlbertanwhoisabletomake   decisionsabouthisorherhealthorrelatedpersonalcaretodayshouldhavetherighttogiveinstructionsaboutwhatdecisionswillbemadeinthefuture. p(#p(# ?' 7)dEX+? Safety0 p Onceanindividualcannolonger H  makedecisions,thatindividualshouldbeprotectedfromthepossibilitythatdecisionswillbemadethataredifferentfromwhatthepersonwouldhavewanted. p(#p(#  Simplicity 0 p Anindividualshouldbeableto r completeallthestepsrequiredtogiveinstructionsaboutfuturecarewithouthavingtogethelpfromalawyerorgotocourt. p(#p(#  Flexibility0 p  #dZddAnindividualshouldbeabletogive#dddZ1 < instructionsaboutanyhealthorrelatedpersonalcarematterthatisimportanttohimorherandiswithinthelaw,inanyformdesired,nomatterhowilladvisedthoseinstructionsmayseemtosomeoneelse. p(#p(#  Ownership 0 p Anyfutureinstructionsmadebyan r'"" individualcannotbechangedorcancelledbyanyoneelsewithoutthepermissionofthepersonwhomadethosefutureinstructionsinthefirstplace. p(#p(#  .))  Unrestricted 0 p Anindividualshouldbeableto  namesomeoneelsetomakehealthandrelatedpersonalcaredecisionsonhisbehalfinthefuture,withoutanyrestrictionsbeingplacedonwhocanbechosen,aslongasthechosenpersonagreestomakethenecessarydecisionsandhasthementalcapacitytomakethosedecisions. p(#p(#  ?' 7)dEX+?ClearAuthority0 p Itmustbeclearatalltimeswhois B  responsibleformakinghealthandrelatedpersonalcaredecisionsonbehalfofanindividualwhocannotmakethesedecisionsforhimselforherself. p(#p(# ?' 7)dEX+? Protection 0 p Anyonewhoismakinghealthand l relatedpersonalcaredecisionsforanotherpersononthebasisthatthosedecisionsarewhattheotherpersonwouldhavewanted,oranyhealthcarepractitionerwhoiscarryingouttheinstructionsofaproxyorinanadvancedirectiveaccordingtoapprovedstandardsofpractice,shouldbeprotectedfromliability. p(#p(#   Doyouagreewiththeseprinciples? Z# Shouldotherprinciplesbeadded?bTD@zx'P p @dddd@E'P dd B'    V Albertaalreadyhaslegislationthatallows x(## individualstogiveinstructionsaboutfuturefinancialdecisions,ortoappointsomeonetomakefinancialdecisionsontheirbehalf,calledthePowerofAttorney +&& Act.Inaddition,foradultswhoarenotabletomake ,'' decisionsontheirown,suchassomepersonswithdevelopmentaldisabilitiesorsomepersonswith .)) Alzheimersdisease,theDependentAdultsActallows  thecourtstoappointaguardianwhowillmakedecisionsforthatperson.However,legislationandthecommonlawisnotclearregardingdecisionmakingauthorityincircumstanceswherementallycapableadultsbecomesuddenly,ortemporarily,incapableofmakinghealthcaredecisionsontheirown.Foranindividualwhowantstoplanforapossiblefutureperiodofincapacity,therearethreeareaswherethatindividualmightwanttogivefutureinstructionsornamesomeonetomakedecisionsontheirbehalf.,0 V Decisionsabouthealthcareonly,whichwould H  includeconsenttoorrefusalofanytreatmentoptionssuggestedbyahealthcarepractitioner.Ofcourse,thiswouldexcludetreatmentoptionswhicharenotavailableinAlbertaornotlegal,suchasassistedsuicide. V(#V(# ,0 V Decisionsabouthealthandrelatedpersonal r care,whichcouldincludedecisionsaboutwheretolive,suchastransferfromahospitaltoalongtermcarecentre,ormattersofpersonalhygieneordietwhicharedirectlyrelatedtohealthandhealthcare. V(#V(# ,0 V Decisionsabouthealthcare,relatedpersonal B careandallotherpersonalcarenotrelatedtohealth,suchasdecidinghowtheindividualdresses,whatmovieshemaysee,etc. V(#V(# ?' 7)dEX+? V Inordertosupportindividualflexibilityinplanningforfuturehealthcaredecisions,theGovernmentisproposingtoincludehealthanddirectlyrelatedpersonalcaredecisionsinthenewlegislation.?' 7)dEX+?  Whatdecisionsdoyouthinkshouldbeincluded? ~)$$    -(( Мd`0 ` 8` `E` dd gd V Anyonewhohasthecapacitytomakeahealthcaredecisionisassumedtobecapableofmakinganadvancedirectiveand/ornamingsomeoneelsetomakedecisionsontheirbehalf.ThegovernmentisproposingthatalladultAlbertansbeassumedtohavethiscapability,withouthavingtodemonstrateproofofmentalcapacity,unlessithasalreadybeenshownotherwise(forexample,personscurrentlyunderguardianshipundertheDependentAdultsAct).  0 d%0 ` 8` `E` ddB  d V But,insomecasesitmaybenecessarytodeterminewhetherapersondoeshavethementalcapacitytomakeahealthcaredecision.Thegovernmentisproposingthatthenewlegislationdefine"capacity"astheabilitytounderstandinformationthatisrelevanttomakingahealthcaredecisionandtoappreciatethereasonablyforeseeableconsequencesofthedecisionornotmakingthedecision.But,mentalcapacityisnotan"allornothing"concept.Apersonmaybeperfectlyabletomakedailydecisionsaboutwhattowear,orwhattoeat,butnothavethecapacitytomakea?' 7)dEX+?complicatedhealthcaredecision.Similarly,apersonmayhavecapacityatsometimesbutnotatothers.Incapacitycanbeatemporaryorpermanentcondition. V Itisimportantthatindividualswhohavethecapacitytomakedecisionsinsomeareasoratsometimesbesupportedinmakingthosedecisions.Havingaproxywiththeauthoritytomakedecisionsdoesnotnecessarilymeanthatallhealthandrelatedpersonal Z# caredecisionsshouldbemadebytheproxy.Ifanindividualcanmakeevensomedecisions,thisshouldbesupportedbytheproxy. V Determiningthatapersondoesnothavethecapacitytomaketheirownhealthandrelatedpersonalcaredecisionsshouldnotbetakenlightly,sinceitmeansthelossofthefundamentalrightofselfdetermination.Exceptincasesofemergencyorwheretheindividualistotallyincapableofcommunicatingtheirwishes(forexample,theindividualisunconscious .)) orinacoma),thegovernmentisproposingthattwoindependentdoctorstrainedinthejudgingofmentalcapacity,wouldberequiredtodeterminewhetheranindividualdoesnothavethecapacitytomakeahealthcaredecision,andtherefore,thecapabilitytomakeanadvancedirective.Inaddition,anyonewhowasjudgedincapableofmakinganadvancedirectiveormakingdecisionsabouttheirownhealthandrelatedpersonalcarewouldbeinformedofthatjudgementandwouldbeabletoappealtothecourts.  Doyouagreethatitshouldbeveryeasyto B  demonstratementalcapacityandmoredifficulttoprovementalincapacity?  T D@zx` p @dddd@E` Xdd   V Unlikeadults,whoshouldbeassumedtohavethecapabilitytomakeanadvancedirectiveunlessitisprovenotherwise,childrenareonlyassumedtohavecapabilitytomakeadirectiveiftwodoctorsattesttotheircapacitytomakeahealthcaredecision.InAlberta,parentsorguardiansusuallymakethesedecisionsfortheirchildren.Butsomeolderchildrendohavethematuritytounderstandtheprobableimpactofmaking,ornotmaking,certainhealthcaredecisions.Everyday,doctorsarefacedwiththequestionofwhetherparticularchildrenwhoareseekingmedicalcareindependentlyfromtheirparentshavethecapacitytomaketheirowndecisions. V Thegovernmentisproposingthatachildwhoisjudgedbytwodoctorstrainedinassessingcapacityashavingthenecessarymaturitytomakehealthcaredecisionspotentiallyalsohasthecapabilitytomakeanadvancedirective.  ?' 7)dEX+? Doyouthinkthatmaturechildrenshould *%% Ѐhavetherighttomakeanadvancedirective?  +&&    .))  V Makinganadvancedirectivewillbeverymuchlikemakingawill.Youwouldneedtowritedowninstructionsaboutyourhealthandrelatedpersonalcare#dnddifyoubecameunabletomakeyourowndecisions.#dddnT  Youcouldalsonamesomeonetomakethesedecisionsforyouandtoexplaintothehealthcarepractitionerswhatyouwouldhavewantedifyoustillcouldmakeyourowndecisions.Youwouldhavetosignanddatetheadvancedirectiveandhavesomeoneelsewitnessyoursignature.Ifyounamedaproxytomakeadecisiononyourbehalf,youshouldalsomakesurethatthepersoniswillingtomakehealthandrelatedpersonalcaredecisionsforyou,ifyouarenotabletodoso. #T D@zxP` p @dddd@EP` Xdd  do0 ` 8` `E ` dd  g d V #d_ddYoucouldchangeorcancelanadvancedirective#ddd_X  f atanytimeandforanyreasonaslongasyouarementallycapabletodoso.Changingorcancellinganadvancedirectivewillbeassimpleasmakingthedirectiveinthefirstplace.Youcouldreplaceanadvancedirectiveatanytimebymakinganewone.Youcangetridofanolddirectivebytearingupyourdirective,bystatinginwritingyourdesiretogetridofthedirective,orbygivingoralinstructionstogetridofthedirective.Ifyouwantedtochangethepersonyouhadnamedasyourproxy,youcouldaddthattothedirective. V Thegovernmentisproposingthatyouarethe#dnddonlypersonwhocanchangeorgetridofyour#dddnZ `$ directiveexceptinonespecialsituation.Ifyouaremarriedandyourspouseisnamedasyourproxy,thisappointmentwouldceaseifyougotdivorcedunlessyouspecificallysaidyouwantedthatpersontobeyourproxyafteryour?' 7)dEX+?divorceaswell.  Whatdoyouthinkabouttheproposedprocessof +&& making,changingandcancellingyouradvancedirective?   .)) Їd0 ` 8` `E` ddB  d V Youcannameanyoneyouknowandtrusttomakehealthandrelatedpersonalcaredecisionsforyouifthetimecomeswhenyoucan'tmakethosedecisionsforyourself.Thispersondoesnothavetoberelatedto  #dsddyoubybloodormarriageitcouldbeyourbest#ddds^  friend,yourbusinesspartneroryourcommonlawspouse.Itcanbeanyonethatyoufeelcomfortablewithtomakedecisionsforyouifyoucan'tmakethemyourself. V Youcouldalsonameagroupofpeople(suchasyourparentsandyouradultchildren)ortheholderof B  aspecificoffice(suchastheheadofareligiousgroup H  #dnddororder).Or,youcouldnameonepersonasyour#dddnu` N  #dnddmainproxy,andnameanotherpersonasanalternate#dddn` T incaseyourmaindecisionmakerwasnotavail?' 7)dEX+?ableorcouldnotmakedecisionsforyouforsomeotherreason. V Theonlyrequirementisthatwhoeveryounameasyourproxymustbeanadultwillingtomakedecisionsonyourbehalf,andmustbementallycapableofmakinganyhealthandrelatedpersonalcaredecisionsthatmayberequired.  Shouldtherebeanyotherconditions < innaminganindividualasaproxy?  B )WGCz|q` Y p @dddd@E!` XddN! ?' 7)dEX+?  +) V  +)Ifitisimportanttoyouanditinvolvesyour T" healthandrelatedpersonalcare,youcanincludeitinyouradvancedirective.Somethingsthatyoumightwanttoincludeare:,0 V alistofparticularmedicaltreatmentsthatyou h'"" wanttogiveyourpermissionforunderspecificcircumstances V(#V(# ,0 V alistofparticularmedicaltreatmentsthatyou x+&& donotwantunderanycircumstances|,''V(#V(# ̛ .)) Ї,0 V instructionsregardinghealthrelatedpersonal  careunderspecificcircumstances V(#V(# ,0 V instructionsregardingorgandonationV(#V(# ,0 V informationaboutyourreligious,cultural,   ethicalorotherpersonalbeliefsthatwouldhelpapersonmakingdecisionsforyou V(#V(# ,0 V thenameandaddressofthepersonorpersons (  thatyouwanttonameasyourproxy V(#V(# ,0 V thenameofanypersonorpersonsthatyoudo 4  notwantasyourproxyunderanycircumstances8V(#V(# ,0 V instructionsforyourhealthcarepractitioner(s) @ incasethepersonsyouhavenamedasagroupasyourproxycannotagreeonadecision V(#V(#  V Youdonothavetoincludealloftheseitemsinyourdirective,butyoumustincludeatleastoneoftheseitemstomakeyourdirectivevalid.?' 7)dEX+?  Arethereanyotherthingsthatyouwould ` liketoincludeinyourdirectivethatarenotincludedinthislist?  h   ,WGCz|` Y p @dddd@E!` dd! `  V Youradvancedirectivewilltakeeffectatthe !p pointwhenyounolongerhavethecapacitytomakehealthcaredecisionsforyourself.Thisoccurswhenyoucannotunderstandtheinformationyouneedtomakeadecision,andyoucannotjudgetheprobableresultsofmakingornotmakingaparticulardecision.Yourdirectivewillstayineffectuntilyouareabletomakedecisionsforyourselfagain.  Arethereanyothercircumstancesinwhichyou :*%% wouldwantyourdirectivetotakeeffect?  >+&&  J.))   d$0 ` 8` `E` \dd %d V Therearealotofreasonswhyyoumightnothaveanadvancedirective.Perhapsyoujustdidn'tgetaroundtoit,orperhapsyoudon'tliketothinkaboutatimewhenyouareunabletomakedecisionsforyourself.Ifyouhaven'tmadeanadvancedirectiveandyoucan'tmakedecisionsforyourself,andyoudontalreadyhaveaguardianappointedundertheDependent   AdultsActoridentifiedundertheMentalHealthAct,   alistofcloserelativesbybloodorthroughmarriagewouldbeusedtoselectsomeonetoactasaproxyforyou.Thispersonwouldhavethesamepowersandresponsibilitiesasaproxynamedinadirective. V Ahealthcarepractitionertryingtofindapersontomakeadecisionforyouwouldchoosethefirstadultpersononthelist,unlessthatpersonwasunavailable.Then,thesecondpersonwouldbechosen,andsoon.Ahealthcarepractitionerwouldalsoturntothelistiftheperson(s)youhadnamedinyouradvancedirectivewasnotavailablewhenneededinanemergency.Theproposedlistincludesthefollowingadultrelatives:,0 V yourhusbandorwifeXV(#V(# ,0 V yourchildrenHV(#V(# ,0 V yourfatherormotherorguardian8V(#V(# ,0 V yourbrother(s)orsister(s) (V(#V(# ,0 V yourgrandparents"V(#V(# ,0 V yourgrandchildren$ V(#V(# ,0 V youraunt(s)oruncle(s)&!"V(#V(# ,0 V yournephew(s)orniece(s)(#$V(#V(# s?' 7)dEX+? V Ifnoneofthesepeoplewereavailabletomakeadecisiononyourbehalf,thenthePublicGuardianor,ifyouareaminor,adirectorundertheChildWelfare ,'( Actwouldmakethedecisions.Nomatterwhatthe -() circumstances,itwillalwaysbecleartoyourhealth .)* carepractitionerswhichpersonisresponsibleformakingadecisionforyou. V Ifyouaremarriedandyourhusbandorwifeisunderage18,heorshewouldnotbeabletomakehealthandrelatedpersonalcaredecisionsonyourbehalf. V Itmighthappenthatthepersonyounamedasyourproxy,orthepersonhighestonthelist,cannotbereachedintimetomakeacriticaldecision,andthen,atalatertimethatpersonbecomesavailabletomakedecisionsforyou.Insuchcases,itisproposedthatthedecisionmakingauthorityreturntothepersonyouoriginallynamed,ortothepersonhighestonthelist.Thatpersonwouldberesponsiblefornotifyingtheactingproxyandthehealthcarepractitionerofhisavailability. V Byputtingthislistintothenewlegislation,yourclosestrelativeswillhavethelegalauthoritytomakedecisionsonyourbehalf(whichtheydonothavenow)evenifyoudonotmakeanadvancedirective.Inmostcases,yourclosestrelativesaremorelikelytoknowwhatyouwouldwantinparticularcircumstancesthananyoneelse.Withoutthislisttoreflectwhomakesdecisionsforyouifyouhaven'tnamedsomeonetodoso,thehealthcarepractitionerscaringforyou,whomaynotknowwhatyouwant,wouldhavetomakethedecisionthemselves.   Istheuseofalistagoodidea? "$|   f*2"`x` `E%` \dd&% f  V Thegovernmentisaskingforyourviewsonthe *&!! useofalistandontheorderofthoseonthelist.Ofcourse,youcouldoverridetheuseofalistbywritinganadvancedirectiveandappointingaproxyorseveralproxies.Youcouldalsonameanyindividualsinyourdirectivewhoyouwouldnotwantasyourproxyunderanycircumstances. ?' 7)dEX+?@2Areyourrelativesonthelistintherightorder?  J.)) ЇdJ0 ` 8` `E` \dd %d V Somemedicalproceduresappeartofallintthescopeofhealthandrelatedpersonalcare,butmaynotactuallybenefitthehealthoftheindividualundergoingtheprocedure.Suchproceduresareoftenbeneficialtoanotherpersonortosocietyasawhole.Theseproceduresinclude:̜,0 V medicaltreatmentifitsmainpurposeisresearch V(#V(# ,0 V pyschosurgery $ V(#V(# ,0 V sterilizationthatisnotmedicallyrequiredto ,  protectyourhealth V(#V(# ,0 V removingtissuefromyourbodywhileyouare 8 alive,fortransplantationtoanotherpersonorformedicaleducationorresearch V(#V(#  V Thegovernmentisproposingthataproxyberestrictedfromconsentingtotheseproceduresonbehalfofanindividual,unlesstheindividualspecificallyconsentstosuchproceduresinadirective.   Doyouagreewiththeserestrictions?Should \ therebeothers? f/2"`x` `E` ddB f V Namingsomeoneasaproxytomakehealthandrelatedpersonalcaredecisionsforyou,ordependingoncloserelativesselectedfromthelistifyouhaven'tmadeanadvancedirective,isanactoftrust.Thegovernmentwantstoensurethatyourwishesarefollowedatalltimes.Thus,any"interestedparty"willhavetheauthoritytoraiseaconcernwiththecourtsiftheythinkthatyouwouldnotwantthedecisionthatyourproxyisabouttomake.This"interestedparty"mightbeanothermemberofyourfamilywhodoesnothaveauthoritytomakedecisionsforyou(perhapsadistantrelativelikeagreatauntorsecondcousin).Itcouldbeaclosefriend,orthepatientinthenextbed.Andcertainly,yourdoctorsandotherhealthcarepractitionerswouldbe"interestedparties". J.))  V Thecourtswillheartheseobjectionstoensurethatyourwishesarerespected.Ifyourproxycontinuestomakeinappropriatedecisions,thenthesesame"interestedparties"cantakethepersontocourtandpetitiontohavethemremovedpermanentlyasyourproxy.Inthiscase,thepersonyouhadidentifiedasyouralternateproxyinyourdirectivewouldtakeover.Orifyouhavenotmadeadirectiveorhavenotnamedanalternateproxy,thentheclosestrelativefromthelistofalternatedecisionmakerswouldtakeovertheresponsibilitytomakedecisionsforyou.?' 7)dEX+?  Arethesesafeguardssufficienttoensurethat 0  thedecisionsmadeforyouwillcontinuetobewhatyouwanted?  8   LWGCz|` Y p @dddd@E` dd@  V Ifyouareaskedbeaproxyforsomeone,youmustconsiderwhetheryouarewillingtotakeonwhatmightbealifeanddeathdecisionforanotherperson.Youragreementisrequiredbeforeyoucanactasaproxy.Ifyoufindoutduringanemergencythatyouhavebeennamedastheproxywithoutyouragreement,youcouldsimplyrefusetoaccepttheresponsibility.Ifyourefuse,thenanyalternativeproxynamedintheadvancedirectivewouldbecomeresponsiblefordecisionmaking.Oriftherewerenoalternativenamed,thenthedecisionmakingauthoritywouldmovetotheclosestrelativeonthelistwhohadnotbeenbarredintheadvancedirective. V Ifyouacceptresponsibility,youshouldbecomeasfamiliaraspossiblewiththefullcontentsoftheindividualsadvancedirective.Youshouldalsodiscusstheindividual'swishesundervariouscircumstanceswiththemuntilyoufeelcomfortablethatyoucouldmakethesamedecisiontheindividualwouldhavemadeforhimorherselfunderavarietyofcircumstances.Astimepasses,youshouldkeepinclosetouchwiththeindividualsothatyouwillbeawareifheorshechangestheadvancedirective,or J.)) changeshisorhermindaboutwhatdecisionwouldbepreferred. V Youshouldalsoconsiderwhereyoustandontheproposedlistofdecisionmakersforyourowncloserelativeswhomaynothavemadeanadvancedirective.Forexample,ifyouaremarried,andyourspouseoryourunmarriedadultchildhasnotmadeanadvancedirective,youwillbethefirstpersoncalledupontomakedecisionsontheirbehalf.?' 7)dEX+?d00 ` 8` `E,` dd, gd V Ifthetimecomesthat,withyourconsent,youaregiventheauthoritytomakedecisionsforsomeoneelse,andadecisionmustbemade,youwillbeexpectedto:,0 V followanyclearandunequivocalinstructionsin @ thewrittenadvancedirective.Iftheinstructionsarenotclearornotrelevanttotheactualcircumstances,thenyouwillbeexpectedto: V(#V(# ,0 V makeadecisionwhichisascloseaspossibleto T thedecisionyoubelievethattheindividualwouldhavemadeforhimselforherself,basedontheindividualsknownbeliefsandvalues,evenifitisnotwhatyouwoulddecideforyourself.Ifyoudon'tknowwhatthepersonwouldhavedecidedforhimselforherself,thenyoumust: V(#V(# ,0 V makeadecisionwhichyouconsidertobein #x thatperson'sbestinterests. V(#V(#  V Thegovernmentisproposingthattheseguidelinesbeusedwheneverhealthandrelatedpersonalcaredecisionsaremadeonbehalfofanincapacitatedindividual.Inordertodothis,aguardianappointedundertheDependentAdultsActoridentified :*%% undertheMentalHealthAct,wouldhavetofollow >+&& thesedecisionmakingguidelines. J.))   Doyouagreethatadecisionmadeforanother  personmustbeascloseaspossibletothedecisionthatpersonwouldhavemadeforhimself,regardlessofhowdifferentfromyourownbeliefsthatdecisionmaybe?     dQ0 ` 8` `E ` dd gd V Therearealotofthingsyoucandotomakesurethatothersknowyouhaveanadvancedirective,including:,0 V notingthelocationofyourdirectiveonyour ,  AlbertaPersonalHealthcardorDriver'sLicense V(#V(# ,0 V makingsurethatyourcloserelativesknowyou < haveadirectiveandwheretheycanfindit V(#V(# ,0 V givingacopyofyourdirectivetoyourdoctor(s) H orotherhealthcarepractitioner(s) V(#V(# ,0 V givingacopyofyourdirectivetoyourlawyerTV(#V(# ,0 V makingsurethatthepersonyouhavenamedas \ yourproxyhasacopyofyourdirective V(#V(#  V TheGovernmentisalsoconsideringsettingupasecure,confidentialregistryforadvancedirectivesthatmedicalprofessionalscouldaccessbycomputer.?' 7)dEX+?  Whatdoyouthinkaboutaformalcomputerized #x registryforadvancedirectives?  "$|   ^WGCz|` . p @dddd@E*&` Xdd*&  V Unlesstheproposedlegislationispassedbythegovernment,yourcurrentlivingwillhasnolegalforce,althoughmostdoctorswilltakeyourstatedwishesintoaccount.Whenadvancedirectiveslegislationispassed,youshouldreviewyourlivingwilltomakesurethatitmeetstheminimalrequirementsforsignaturesoranyotherthingsrequiredbythenewlegislation.Itismostlikelythatyouwillnotneedtomakeanychangessincethe J.)) proposedlegislationwillsupportmaximumflexibilityforindividualsinwritinganadvancedirective.  Shouldthelegislationvalidatelivingwills   whichweremadebeforethelegislationispassed?     d0 ` 8` `E ` \dd %d V Ifyouhavemadeanadvancedirectivenamingaproxy,thentheadvancedirectivecouldreplacetheneedtogotocourttohaveaguardianappointedtomakehealthandrelatedpersonalcaredecisions.. V Incaseswheretheneedforadecisionmakercontinuesforalongperiodoftimeandislikelytoremainpermanent,itmaybedesirablefordecisionmakerswhoareappointedfromthelist,ratherthannamedasaproxyinanadvancedirective,toobtainpermanentguardianshipfromthecourts.  ?' 7)dEX+?Whatdoyouthink?  H WGCz|`  p @dddd@E` \dd '   V Thereareseveralareaswhereindividualsor"interestedparties"maywanttoappeal,includingthefollowingcases:,0 V ajudgementthattheindividualismentally ` incapacitatedandnotabletomakedecisionsforthemselves V(#V(# ,0 V theassumptionofmentalcapacity(foranadult)  @ ortheverificationofcapacity(forachild),andthevalidityofanadvancedirective. V(#V(# ,0 V thedeterminationofwhoisallowedtoactasa $  proxy V(#V(# ,0 V aparticulardecisionthatisabouttobemadeby '## aproxyifitisfeltthatthedecisionisnotwhattheindividualwouldhavewanted. V(#V(#  V Theproposedlegislationsuggeststhatthecourtshearappealssuchasthoseidentifiedabove.Afterlegislationonadvancedirectivesispassed,anappealpanelcouldbeestablishedtodealwithappealsor .** objectionsratherthanreferringtheissuesdirectlytothecourts.Ifanindividualorinterestedpartyisnotsatisfiedwithadecisionofthepanel,hecouldstillappealtothecourts.  Doyouthinkthatanappealpanelshouldbe   established?      d50 ` 8` `E ` \dd $d V Allofthekeyissueswhichareaddressedintheproposedlegislationareidentifiedinthisdocument.#dTddTheresultsofthefeedbackobtainedfromAlbertanswill (  #dddTshapethefinallegislation.Inaddition,likemostpieces ,  oflegislation,therearealsoanumberofadministrativemattersaddressedbythebill,suchasmakingamendmentstootherrelatedlegislation,providingforministerialregulatoryauthority,etc..d80 ` 8` `E` dd fd?' 7)dEX+? V AnyAlbertanwhowantstogetmorecontroloverwhatwillhappentotheirhealthandrelatedpersonalcareiftheyshouldbecomeincapableofmakingdecisionsforthemselveswillbenefitfromthisproposedlegislation.Thefamiliesofindividualswhomakeanadvancedirectivewillfeelmorecomfortableknowingthatthedecisionsbeingmadearewhattheindividualwanted.Doctorsandotherhealthcarepractitionerswillhaveclearguidelinestofollowinprovidinghealthandrelatedpersonalcareforan#dSddincapacitatedindividualandwillbeabletowork#dddSݯԀclosely  l withanidentifiedproxyinmakingdecisionsforthatindividual.7WGCz|`  p @dddd@E&%` ddB&%  V Thisimportantpieceoflegislationwillenhanceindividualcontrolovercriticaldecisionsregardinghealthandrelatedpersonalcareintheeventofmentalincapacity.AnumberofAlbertanshaveexpressedadesiretogainthisadditionalcontrol.Thisdiscussionpaperidentifiesthekeyissuesintheproposedlegislation.Yourcomments,opinionsandviewsontheseissues,oronanyothermatterthatyoumightwishtoaddress,areencouraged.Yourcommentscanmakeadifference. J.)) ?' 7)dEX+?@]]= PLEASESENDYOURCOMMENTSTO:     HonourableShirleyMcClellanMinisterofHealth127LegislatureBuilding1080097AvenueEdmonton,Alberta,T5K2B6    91:(C ;  #EC< ?' 7)dE 7)? k  YOURVIEWSAREIMPORTANT!    q=p kThesepageshavebeenpreparedtoassistyouinprovidingfeedbacktotheHonourable 0 ShirleyMcClellan.PleasetakeafewmomentsofyourtimetofilloutthissurveyontheissuesraisedinDecisionsaboutTomorrow:DirectivesforYourHealthCare.. $ Eachstatementcouldhaveanumberofresponses.Therearenorightorwronganswers.Itisimportantthatyouletthegovernmentknowhowyoufeelonthesecriticalissues.Pleaseindicatewhetheryou:StronglyAgreecheckthe" SA "box%     Agreecheckthe" A "box   Havenoopinionorareneutralcheckthe" N/R "box   Disagreecheckthe" D "box   StronglyDisagreecheckthe" SD "box   *q>? ddd Xdd Xdd X(#(#q,dd ,Xtd ,Xtd ,Xtd ,Xtd ,Xtt +  ( | |t( )= J )@F SA 6=!J= 6@N A 6=!J= 6@TT N/R 6=!J= 6@aa\ D 6=!J= 6@w!w!a! SD ?5!J t0 | = t?1.0 l TheAlbertagovernmentshouldpassl l  0 l legislationtostrengthenindividualcontroloverfuturehealthandrelatedpersonalcaredecisions. -|l l  - 0! 0 0! 0 0! 0 4! 4 ?5!  t0   t?2.0 l Thelegislationallowanindividualtot!l l  0 l writeanadvancedirectiveor"livingwill". l l   # h# # 0!t$ 0 0!t% 0 0!t& 0 4!t' 4 ?5!t( t0   t?3.0 l Thelegislationshouldallowanindividualto ) nameaproxyorproxiestomakedecisionsonhis/herbehalfiftheindividualbecomesincapacitated. -",l l  - 0!- 0 0!. 0 0!/ 0 4!0 4 ?5!1 t0   t?4.0 l Thelegislationshouldincludealistofclose 8$2 relativeswhocouldbecalledonifan l l  0 l advancedirectivedoesnotexist. -,&!4l l  - 0!8$5 0 0!8$6 0 0!8$7 0 4!8$8 4 ?5!8$9 t0   t?5.0 l Theproposedprinciplesforthelegislation'$#:l l  0 l areappropriate. l l   # )%< # 0!'$#= 0 0!'$#> 0 0!'$#? 0 4!'$#@ 4?5!'$#A t0   t?6.0 l Thelegislationshouldberestrictedtohealth t caredecisionsonly:relatedpersonalcaredecisionsshouldnotbeincluded. l l   #  b # 0!t 0 0!t 0 0!t 0 4!t 4 ?5!t  t0   t?7.0 l Thelegislationshouldincludethefacilityto D   makebothhealthcareanddirectlyrelatedpersonalcaredecisions. -8  l l  - 0!D   0 0!D  0 0!D  0 4!D  4 ?5!D  t0   t?8.0 l Thelegislationshouldincludetheabilityto  makehealthcare,relatedpersonalcareandallotherpersonalcaredecisionsnotrelatedtohealth. - l l  - 0! 0 0! 0 0! 0 4! 4 1'! t0   t19.0 l Anindividualmakinganadvancedirective b  shouldbeabletoincludeanythingabout l l  0 l healthandrelatedpersonalcarethatisimportanttothem. $P l l  $ 'b  ' 'b  ' 'b ! ' +b " + :0b # t0  t:10.0 l Twoindependentdoctorsshouldberequired$l l  0 l todeterminewhetheranindividuallacksthecapacitytomakeanadvancedirective. -&l l  - 0!' 0 0!( 0 0!) 0 4!* 4 ?5!+ t0   t?11.0 l Iftwodoctorsattesttothematurityofa<,l l  0 l minorchild,thenthatchildshouldbe l l  0 l allowedtomakeanadvancedirective. -t0.l l  - 0!</ 0 0!<0 0 0!<1 0 4!<2 4 ?5!<3 t0   t?12.0 l Anadvancedirectiveshouldbeconsidered 4 validifitissigned,andwitnessedbyoneperson. -!6l l  - 0!7 0 0!8 0 0!9 0 4!: 4 ?5!; t0   t?13.0 l Anindividualshouldbeabletochooseasa "`< proxyeitherasingleperson,agroupof l l  0 l personsoraholderofaparticularoffice. -$T>l l  - 0!"`? 0 0!"`@ 0 0!"`A 0 4!"`B 4 ?5!"`C t0   t?14.0 l Anadvancedirectiveshouldonlycomeinto 6&D effectatthepointwhenanindividual l l  0 l becomesmentallyincapableofmakingtheirowndecisions. -$)"Gl l  - 0!6&H 0 0!6&I 0 0!6&J 0 4!6&K 4 ?5!6&L t0   t?15.0 l Ifanindividualhasnotmadeanadvance *~$M directive,thestatutorylistofcloserelativesshouldbeusedtodeterminewhohas l l  0 l authoritytomakedecisions. --l'Pl l  - 0!*~$Q 0 0!*~$R 0 0!*~$S 0 4!*~$T 4 1'!*~$U t0   t116.0 l ThePublicGuardianshouldbethedefault t  decisionmakerifanindividualhasno l l  0 l relativeswhoarewillingorabletomakedecisionsfortheindividual. $ bl l  $ 't ' 't ' 't ' +t + ,"t  t0  t,17.0 l Aproxyshouldberestrictedfromconsentingto D   medicalproceduresofnobenefittotheindividual,unlessotherwisespecifiedintheindividualsdirective. $2 l l  $ 'D  ' 'D  ' 'D  ' +D  + :0D  t0  t:18.0 l Any"interestedparty"shouldhavetheright l l  0 l toappealdecisionsthattheybelievedonotreflectthewishesoftheincapacitatedindividual. -z l l  - 0!  0 0!  0 0!  0 4!  4 ?5!  t0   t?19.0 l Anincapacitatedpersonhastherightto\l l  0 l expectthatdecisionsmadeonhis/herbehalf l l  0 l areascloseaspossibletothedecisions l l  0 l he/shewouldhavemadepersonally. -Jl l  - 0!\  0 0!\! 0 0!\" 0 4!\# 4 ?5!\$ t0   t?20.0 l Thegovernmentshouldestablishaprovince % widecomputersystemforthevoluntaryregistrationofadvancedirectives. l l   # ( # 0!) 0 0!* 0 0!+ 0 4!, 4 ?5!- t0   t??'v 'dEn%'?21.0 l Anindividualshouldberequiredtoregistert0.l l  0 l anadvancedirectiveforittobecomelegal. l l   # h$0 # 0!t01 0 0!t02 0 0!t03 0 4!t04 4 ?5!t05 t0   t?22.0 l Alivingwillmadebeforethelegislation!6l l  0 l comesintoforceshouldbeacceptedasa l l  0 l validadvancedirective. l l   # #9 # 0!!: 0 0!!; 0 0!!< 0 4!!= 4 ?5!!> t0   t?23.0 l Ifanindividualhasnamedaproxy,andlong %N? termdecisionmakingisrequired,thatproxyshouldnothavetoobtainguardianshipundertheDependentAdultsActinordertomake (<"B healthandrelatedpersonalcaredecision. -z)6#Cl l  - 0!%ND 0 0!%NE 0 0!%NF 0 4!%NG 4?5!%NH t0   t?24.0 l Ifanindividualhasaproxyselectedfromtl l  0 l thelist,andlongtermdecisionmakingisrequired,thatproxyshouldnothaveto l l  0 l obtainguardianshipundertheDependent  b AdultsActinordertomakehealthand \l l  0 l relatedpersonalcaredecisions. - Vl l  - 0!t 0 0!t 0 0!t  0 4!t  4 1'!t  t0   t125.0 l Thegovernmentshouldestablishaseparate 8   appealmechanismtohearmostappeals l l  0 l insteadofreferringallappealsdirectlytothecourts. $& l l  $ '8  ' '8  ' '8  ' +8  + :08  t0  t:25.0 l Difficultissuesshouldbesettledbyappealto   thecourts. l l   # t  # 0!  0 0!  0 0!  0 4!  4 ?5!  t0   t?26.0 l Ithinkthislegislationisanexcellentidea.Vl l   # J # 0!V  0 0!V! 0 0!V" 0 4!V# 4 C9!V$ t0   t@C27.0 l Iintendtowriteanadvancedirectiveassoon%l l  0 l asthelegislationisproclaimed. l l   % ' % 2!( 2 2!) 2 2!* 2 4!+ 41'%, t@    1    Itwouldbehelpfultoknowalittlebitofinformationaboutyouinordertohelpustoanalyzetheresponsestothissurvey.Itwouldbeappreciatedifyoucouldalsoanswerthefollowingquestions:{[Xr h x (#%'0*,.8135@8:<H?Ah XpX{ Age :&  Under18yearsold   h MaritalStatus :0  &  Single!2(#(#  r &  18to30yearsold   h     0  &  Marriedor"3(#(#  r &  31to45yearsold   h       0  livingtogether#4(#(#  r &  46to60yearsold   h     0  &  DivorcedorSeparated$5(#(# c   r c&0    61to75yearsold   h     0(#(#&  Widowedc݌%6(#(# Ќ   r &0  76yearsoldorolder& 7(#(# [Xr <h x (#%'0*,.8135@8:<H?A Xr XX i7,Xr * L!(#X Xr <hXiAreainAlberta :& Edmonton  & * Urbancentral  Gender :  & L Male ("9  r    & Calgary  & * Ruralcentral  0  0 (#(#& L Female)~#: (# (#  r    & Urbannorth  & * Urbansouth *x$;  r    & Ruralnorth  & * Ruralsouth +r%<  Healthprofessional/workinthehealthsystem:0  0(#(# &  Yes0 (#(#& L No -f'> (# (#  PLEASEUSETHISPAGETOEXPRESSANYOTHERVIEWS,OPTIONS,  ALTERNATIVES,ORIDEASABOUTTHEPROPOSEDLEGISLATION.YOUMAYUSEADDITIONALSHEETSIFREQUIRED.WEWELCOMEYOURCOMMENTSANDCONCERNS.   ?' xdE{ x? |  ?'  xdE x?    ?' T xdEx?   ?' $xdEx?   ?' xdEx?  ?' xdEx? 0 ?' xdEx? B ?' xdEx? T# ?' xdE x?  f' ?' xdEx? x+ ?' xdE/ x? 0 / ?' xdEA"x? B"3 ?' xdES$x? T$7 ?' xdEe&x? f&!; % 4  p q= @ee PLEASESENDYOURCOMMENTSBYDECEMBER31,1994TO:  &!=   HonourableShirleyMcClellanMinisterofHealth127LegislatureBuilding1080097AvenueEdmonton,Alberta,T5K2B6# q=p #% 6