No, you do not need to appoint a Representative through a Representation Agreement, nor are you required to have an Advance Directive. You may opt to instead allow your healthcare provider to choose a Temporary Substitute Decision Maker (TSDM) in the event a decision needs to be made regarding your healthcare and you are unable to communicate your wishes. A TSDM is appointed by your health care provider who must choose the first, in listed order, of the following who is at least 19 years of age or older, have been in contact with you in the past 12 months, currently has no dispute with you, is capable of giving, refusing or revoking substitute consent and is willing to comply with their duties under section 19 of the health care (consent) and care facility (admission) act:
The adult's spouse; The adult's child; The adult’s parent; The adult's brother or sister; the adult's grandparent; the adult's grandchild; Anyone else related by birth or adoption to the adult; A close friend of the adult; A person immediately related to the adult by marriage.