In the state of California, you have the right to give instructions about your healthcare. The ideal situation is to be able to give these directives yourself, directly. Unfortunately, situations can arise when a person is unable to personally make healthcare decisions. If you ever find yourself in such a position, you are best served having preselected a person who will make certain healthcare decisions on your behalf. You accomplish this by creating what is known in California as an Advanced Health Care Directive.
Before creating and signing an advanced healthcare directive, it is important that you have a complete and solid understanding of what this legal instrument can and cannot do. We provide you with a thorough review of a California Advanced Healthcare Directive. In this regard, this comprehensive review of making and implementing an Advanced Healthcare Directive addresses these important issues:
- Keys to selecting a proper person to make healthcare decisions for you
- Understanding when an Advanced Healthcare Directive goes into effect
- Five general areas of decision-making authority in an Advanced Healthcare Directive
- Delineating the extent and type of medical care at the end of life
- Directives on organ donation
- Designated primary care physician
- Signing an Advanced Healthcare Directive
- Revoking an Advanced Healthcare Directive
Keys To Selecting a Proper Person To Make Healthcare Decisions for You
There are a number of keys that need to be applied when it comes to selecting an appropriate person to make healthcare decisions for you:
- You certainly need to select a person you trust. What is known as your agent-in-fact for healthcare decisions needs to be a person that you have complete confidence will carry out your wishes and protect your interests when it comes to medical care when you cannot do so for yourself.
- The person you designate in your Advanced Healthcare Directive needs to be a person who you know will be readily available should you ever be in a position when you cannot make medical decisions for yourself. In other words, a person you select to make healthcare decisions for you needs to be in the community in which you reside.
- You need to pick a person who will have the time to deal with medical decision making on your behalf.
- The person you select to represent your interests in your Advanced Healthcare Directive needs to have a sufficient understanding of some of the essential elements of seeking and obtaining medical care and treatment.
Understanding When an Advanced Healthcare Directive Goes Into Effect
An Advanced Healthcare Directive doesn’t go into effect when you are capable of making healthcare and medical decisions for yourself. An Advanced Healthcare Directive is only triggered when you are incapable of making medical decisions for yourself.
There are two overarching reasons governing when your Advanced Healthcare Directive goes into effect. First, you may be in a physical condition that prevents you from making medical decisions for yourself. By way of example, if you ended up in a coma as a result of injuries from a car accident, your Advanced Healthcare Directive would go into effect.
Second, an Advanced Healthcare Directive can go into effect if you have a mental health issue that renders you mentally incompetent and unable to make healthcare decisions for yourself. For example, if you developed some sort of mental health condition that resulted in you being in a psychotic state, your Advanced Healthcare Directive would go into effect due to your lack of mental capacity.
Five General Areas of Decision-Making Authority in an Advanced Healthcare Directive
A California Advanced Healthcare Directive contains five general areas of decision-making authority for the person you select to make medical choices on your behalf. These are:
- Consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition.
- Select or discharge health care providers and institutions.
- Approve or disapprove diagnostic tests, surgical procedures, and programs of medication.
- Direct the provision, withholding, or withdrawal of artificial nutrition and hydration and all other forms of health care, including cardiopulmonary resuscitation.
- Donate your organs, tissues, and parts, authorize an autopsy, and direct disposition of remains.
Delineating the Extent and Type of Medical Care at the End of Life
In addition to containing information pertaining to the appointment of a person to make medical decisions on your behalf, and the scope of that individual’s authority, an Advanced Healthcare Directive also includes directives pertaining to end of life decisions. Simply put, an Advanced Healthcare Directive essentially contains the provisions of what standing alone would be a Power of Attorney for Healthcare as well as a Living Will.
At the heart of this element of an Advanced Healthcare Directive is your directive to permit or not use extraordinary procedures to keep you alive when death otherwise is imminent. For example, you can elect to forgo certain types of life sustaining medical care like a ventilator or resuscitation and yet direct the provision of palliative care when you reach the last stages of your life.
Directives on Organ Donation
Your Advanced Healthcare Directive can also include provisions regarding the disposition of your organs after you die. Your Advanced Healthcare Directive can direct that organs be donated to a person with a medical need. You can elect to donate your entire body to research.
Designate a Primary Care Physician
If you are like many people, who currently have a primary care physician or at least a doctor that you particularly trust, an Advanced Healthcare Directive provides you the ability to name your primary care physician.
Bear in mind that the primary care physician named in your Advanced Healthcare Directive can be part of the decision-making process when the instrument comes into effect. Together with the agent you designate in your Advanced Healthcare Directive, the participation of your primary care physician works to ensure your wishes are appropriately carried out.
Signing an Advanced Healthcare Directive
California law requires that you sign your Advanced Healthcare Directive in the presence of two witnesses. Under the provisions of California law, each witness attests to the following:
- The individual who signed this Advanced Healthcare Directive is personally known to the witness.
- The individual signed the Advanced Healthcare Directive in the presence of the witness.
- The individual who signed the Advanced Healthcare Directive appears to be of sound mind and under no duress, fraud, or undue influence.
- The witness is not the agent appointed by the Advanced Healthcare Directive.
- The witness is not the individual’s health care provider, an employee of the individual’s health care provider, the operator of a community care facility, an employee of an operator of a community care facility, the operator of a residential care facility for the elderly, nor an employee of an operator of a residential care facility for the elderly.
In addition, at least one of the two witnesses must be unrelated to you.
Revoking an Advanced Healthcare Directive
You can revoke your Advanced Healthcare Directive in a number of ways. First, you can tear up your existing Advanced Healthcare Directive.
Second, you can execute a new Advanced Healthcare Directive. The one created later in time is the one that will govern.
Third, you can write a document that expressly revokes an existing Advanced Healthcare Directive. Fourth, you could include an ending date within an Advanced Healthcare Directive. In other words, you can set a specific timeframe during which an Advanced Healthcare Directive will be effective.