Park LaBrea News/Beverly Press, By Stephen Kramer Esq.


Who Will Decide When You Can’t?  California law provides each of us with the ability to make sure that our health care wishes are known and complied with in the event we are ill or incapacitated and unable to make these decisions ourselves.  Any adult acting of his or her own free will may complete an Advance Health Care Directive.  The expression of your wishes is a private matter between you and your Agent.  

What Is An Advance Health Care Directive?  An Advance Health Care Directive (AHCD) is a document in which you name a person, your Agent, to speak for you if you should become unable to speak for yourself regarding health care and related issues. 

In the event that you cannot speak for yourself, an AHCD gives authority to your Agent to carry out your wishes regarding choice of hospital, support staff, your doctor, treatment, as well as end-of-life issues.  Health care providers must follow your Agent’s lawful instructions.

An AHCD allows you to: (1) appoint another person to be your health care “Agent,” and (2) write down your health care wishes.  Your Agent will have legal authority to make decisions about your medical care if you become unable to make these decisions for yourself.  Your Agent must make decisions that are consistent with any instructions you have written in the Advance Health Care Directive or otherwise made known to your Agent.  Additionally, you may express a desire to receive, or not receive, pain relief, cardiopulmonary resuscitation, intravenous feeding, surgical procedures, treatment that prolongs your life if you are terminally ill, and other end-of-life issues.  Your doctor and your Agent must follow your lawful instructions.

Why Do I Need An AHCD?  The importance of having an AHCD cannot be overstated.  Privacy laws and liability issues have made it increasingly difficult for doctors and hospitals to discuss medical matters with family members – even a spouse or parent!  Consequently, without an AHCD, you risk that it will not be your loved ones making decisions about your health care but rather the Courts or hospital administrators.

In response to the importance of every adult having an AHCD, the California Secretary of State established a state-wide AHCD Registry.  You may file your AHCD with the Registry, or you may note the location of your AHCD on the Registry.  If you should become injured, ill, or otherwise unable to speak for yourself, your healthcare provider or legal representative may request from the Secretary of State the information you filed with the Registry.

Whom May I Appoint As My Health Care Agent?  You may appoint almost any adult to be your Agent.  You may choose a member of your family such as your spouse or an adult child, a friend, or someone else you trust.  You may also appoint one or more “alternate Agents” in case the person you select as your health care Agent is unavailable or unwilling to make a decision.

The law prohibits you from choosing your doctor or a person who operates a community or residential care facility in which you receive care or any of their employees unless that person is related to you by blood, marriage, or adoption, or is a co-worker.

How Much Authority Will My Health Care Agent Have?  If you become unable to make your own health care decisions, your Agent will have legal authority to make health care decisions for you.  Your Agent must make decisions that are consistent with any instructions you have written in the AHCD or otherwise made known to your Agent.  Physicians and other health care professionals will look to your Agent for decisions.

If you have not made your wishes known, your Agent has broad powers to decide what is in your best interest, considering your personal values to the extent they are known.  (Certain procedures specified by law may not be authorized by your Agent, such as convulsive treatment, psychosurgery, sterilization, or placement in a mental health treatment facility.)

Some of the specific powers which you may give or deny your Agent in the AHCD include the power to terminate life support and the authority, after you die, to make organ donations, authorize or refuse an autopsy, and direct the disposition of your remains.

Can I Change My Advance Health Care Directive?  You may revoke or change an AHCD at any time.  Completing a new AHCD will revoke all previous instructions.  If you revoke or change your AHCD, you should notify every person or facility that has a copy of your prior document and provide them with a new one.

Can I Be Forced Or Required To Sign An Advance Health Care Directive?  No.  The law specifically says that no one can require you to complete an AHCD before admitting you to a hospital or other health care facility, and no one can deny you health insurance because you choose not to complete an AHCD.

Do I Need An Attorney To Complete An Advance Health Care Directive?  No.  You do not need an attorney to assist you in completing an AHCD form.  The only exception applies to individuals who have been involuntarily committed to a mental health facility who wish to appoint their conservator as their Agent.

For How Long Is An Advance Health Care Directive Valid?  An AHCD is valid forever unless you revoke it or state a specific date in the document when it is to expire.What About Documents I Signed Many Years Ago?  The AHCD replaces documents such as Durable Powers of Attorney for Health Care, the California Natural Death Act Declarations, and other documents often called “living wills.”  The validity of these documents can vary.  You should consult with an attorney if you are in doubt.