British Columbia does advance care planning a little differently from the rest of Canada. Its main instrument is the Representation Agreement, which is the document that names the person who’ll make your healthcare decisions and records the wishes that guide them. B.C. also offers a second, optional instrument, the Advance Directive, which, despite its name, many people don’t need. Understanding when the second one actually helps, and its downsides, is the key to getting it right in B.C.
Here is how the pieces fit.
The main document: the Representation Agreement
A Representation Agreement names a person — your representative — to make personal-care and healthcare decisions for you if you can’t. Just as importantly, it’s also where you record your wishes, values, and beliefs, which your representative is required to follow.
That second part gets overlooked. A Representation Agreement isn’t only about who decides; it carries what you want, too. Your representative must act consistently with the wishes you’ve expressed while capable, and where they don’t know your specific wish, they must act on your known values and beliefs. So, for most people in B.C., a single well-made Representation Agreement covers both halves of advance care planning: the decision-maker and the wishes that direct them.
You do not need a separate document to record your wishes. They belong in the Representation Agreement itself.
The optional second document: the Advance Directive
B.C. also has an Advance Directive, which is a document that sets out specific healthcare instructions your care team can act on directly, without going through your representative. This is where B.C. differs from most provinces, and where care is needed.
An Advance Directive is not a document that everyone should add. It’s a specialized tool for a specific situation: when you have a particular instruction you want followed exactly, on its own terms, even if you’re not there to explain it and even if your representative might have read the moment differently.
Most people don’t need one. If you trust your representative to weigh real situations as they arise (which is the whole reason you chose them), recording your wishes in the Representation Agreement and letting that person apply them is usually the better path. The representative can take in the actual circumstances, ask the medical team questions, and judge how your values apply to a situation no document could have fully anticipated.
When an Advance Directive does make sense: If you have a clear, categorical instruction that you want honoured on its own terms, no matter the circumstances, an Advance Directive is a good tool. A Jehovah’s Witness who knows with certainty she never wants a blood transfusion, under any conditions, is the classic example. The point is precisely that no one, not even a trusted representative, should be able to weigh that decision away in the moment. Similarly, you might know that, due to your circumstances, you never want to receive CPR. An Advance Directive lets you categorically refuse this.
That strength is also the risk. An Advance Directive can become a heavy, blunt tool. Because a care team can act on it directly, it removes your representative’s judgment from the loop for whatever it covers. A directive drafted too broadly (or written for one scenario but worded to catch many) can bind your care in situations you never had in mind, at exactly the moment you’d have wanted a trusted person weighing the specifics. What looks like extra protection can quietly take a person you trust out of the decision.
So the rule of thumb: put your wishes in the Representation Agreement and let your representative carry them, unless you have a specific, categorical instruction that genuinely must bind directly. If you do use an Advance Directive, keep it narrow and precise, and get the wording right.
Section 7 vs. Section 9: the part everyone asks about
B.C.’s Representation Agreement Act offers two types of Representation Agreement, named after the sections of the Act that create them. They differ in how much authority they grant and what capacity you need to make one.
Section 7 — “standard” agreements. A Section 7 agreement covers a more limited, defined set of routine matters, including some personal care, minor and major healthcare, and certain routine financial affairs. Crucially, the capacity test for making a Section 7 agreement is lower. Even someone who might not meet the standard test for legal capacity can often still make a Section 7 agreement, because the Act looks at factors like whether you trust the person and are aware of the relationship. This makes Section 7 important for people whose capacity is in question but who can still express trust and preferences.
Section 9 — broader agreements. A Section 9 agreement allows you to give your representative much broader authority over healthcare and personal-care decisions, including the kinds of significant decisions a Section 7 agreement doesn’t reach. The trade-off is that making a Section 9 agreement requires you to be capable in the fuller sense: you must understand the nature and consequences of what you’re granting.
In short, Section 9 grants broader healthcare authority but requires fuller capacity, while Section 7 is narrower but accessible at a lower capacity threshold. For most people doing proactive advance care planning while fully capable, the Section 9 agreement is the instrument that grants their representative meaningful authority over healthcare decisions.
How to make a Representation Agreement
A Representation Agreement in B.C. must be in writing, signed by you, and signed by your representative, with witnessing that meets the Act’s requirements. The witnessing rules and the number of witnesses depend on the circumstances, and certain people are excluded from acting as witnesses. B.C. also has a voluntary central registry, the Nidus Registry, where Representation Agreements can be recorded.
A note on accuracy: B.C.’s requirements come from the Representation Agreement Act and the Health Care (Consent) and Care Facility (Admission) Act. The Section 7 / Section 9 distinction, witnessing rules, and capacity tests have real legal nuance. This guide is educational, not legal advice. Confirm current requirements, and if Tiller produced your document, follow its instructions exactly.
When no representative is available
B.C. law includes a useful safeguard. Even where no representative has been appointed and no representative is available to act, healthcare providers are required to take your known wishes and beliefs into account when a substitute decision-maker is making a decision on your behalf. In practice, this means the values and wishes you’ve recorded carry weight even outside the Representation Agreement by helping guide whoever ends up deciding.
That’s a strong reason to record your wishes clearly, regardless of which documents you complete.
What Tiller produces in B.C.
Tiller helps B.C. users create a Section 9 Representation Agreement, which is the instrument that names your representative, grants them healthcare decision-making authority, and records the wishes, values, and beliefs they’re required to follow. It’s formatted to B.C.’s requirements.
This is a deliberate scope choice. The Section 9 Representation Agreement is the document that most closely matches what advance care planning looks like in the rest of Canada: a trusted person, empowered to decide, guided by your wishes. It’s the right instrument for the large majority of people, and it puts a person you chose at the centre of your care rather than a document acting on its own.
Tiller does not produce a B.C. Advance Directive, by design. As explained above, an Advance Directive is a specialized, heavier tool, one that can bind your care team directly and remove your representative’s judgment from the situation. For the narrow cases where a categorical, directly binding instruction is genuinely what someone wants, that’s a decision worth making carefully, usually with a B.C. lawyer or clinician who can help ensure the wording does exactly what’s intended and no more.
So, if you want a trusted person to carry your wishes and apply them to real situations, Tiller’s Section 9 Representation Agreement is built for you. If you have a specific, categorical instruction that must bind directly, complete an Advance Directive with professional help alongside the Representation Agreement Tiller produces.
How Tiller helps
Tiller guides you through a Section 9 Representation Agreement formatted to B.C.’s requirements, helps you choose your representative, and walks you through articulating the values and wishes that will guide healthcare decisions on your behalf.
Tiller produces a document formatted to B.C.’s requirements for a Section 9 Representation Agreement. Legal validity depends on completing the signing and witnessing steps correctly — Tiller walks you through them.
Related reading: