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This article is a comparative study of the law dealing with substitute decision making for incapable patients in end-of-life situations across Canadian provinces. In recent years, this issue has received growing consideration from judicial authorities in Canada and abroad. The article discusses the most significant decisions in Canada, with reference as well to leading cases in the UK, Germany and the US. Future policy and legislative options are discussed as well.

Patients have a right to be informed and actively involved in their health care. Fundamental to a person's dignity and autonomy is the right to make decisions about their psychiatric treatment, including their right to refuse unwanted treatments, providing that the refusal is a capable one. It is important that psychiatrists have an awareness of the ethical underpinnings of consent and the legislated requirements related to consent, including precedent cases. Consent may change over time and for different conditions and circumstances. Consent must be an ongoing process. [ABSTRACT FROM AUTHOR]