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  • By: Taylor Preston, Esq.
California Advance Healthcare Directive legal guide.

In this article, you will discover:

  • What an advance healthcare directive is and why you should have one
  • The types of decisions you can make through an advance healthcare directive
  • Why you should have an attorney help you draft your advance healthcare directive

What Is An Advance Healthcare Directive, And Why Should I Have One In California?

An advance healthcare directive is a document you establish exclusively for your medical decisions or the disposition of your remains upon your incapacity. This document can be used while you have capacity, if you grant someone the ability, or only upon your incapacity.

The advance directive’s purpose is to allow someone to make your medical decisions for you if you otherwise can’t do so. An advance healthcare directive is similar to a power of attorney, except the directive is exclusively for medical decisions, as opposed to the financial or legal decisions in a standard power of attorney.

Many hospitals will give you a basic Advance Health Care Directive form to fill out, which they keep on file. The hospital usually wants you to fill it out before an upcoming, risky operation or medical procedure.

Advance healthcare directives are always useful to have in place. Suppose you don’t have one and you lose the requisite capacity to make your own medical decisions due to a coma, dementia, Alzheimer’s or other condition. In that case, the alternative is usually having to file for a conservatorship.

A conservatorship is a complex, expensive and time-consuming process. It requires ongoing court supervision throughout the duration. The court does not favor conservatorships if a power of attorney or medical directive is in place ahead of time. Those are less restrictive alternatives to conservatorship, which is favored by just about everybody involved, the court included.

Setting up a healthcare directive is always the best option because life is unpredictable. It’s wisest to hope for the best and prepare for the worst. Suppose you can no longer make your own medical decisions. In that case, a directive allows your family or whoever you have nominated as your agent under the directive to step in and make the decisions you directed ahead of time. This decision prevents your family from getting stuck in court and all the issues that come along with that process.

Which Decisions Should Be Included In An Advance Healthcare Directive?

The decisions can be very narrow or very broad. Those decisions might involve:

  • Whether to prolong your life if you’re in a permanent vegetative state, irreversible coma or in a terminal state with no chance of survival
  • Whether to remove or administer a feeding tube
  • Whether to force-feed or not force-feed In the event of severe incapacity
  • Whether to administer CPR
  • Discontinuing medical services
  • Discontinuing life support
  • Providing pain management medications
  • Discontinuing treatment if another condition comes up
  • Electing organ donation
  • Authorizing an autopsy on your passing
  • Designating a primary physician or multiple primary physicians for a second opinion
  • Designating how many physicians need to give an opinion before a decision is made
  • Determining how many days need to elapse before deciding to cease life-sustaining treatment

The directive can also include a nomination for a conservatorship if that were ever to become necessary. You can list several co-agents or multiple agents to serve in order of succession if someone is not available.

All of these decisions are difficult. For example, if you’re on life support and then develop cancer, a decision could be made not to treat the cancer. I always advise clients to make these decisions ahead of time to ensure their wishes are followed.

The decisions can be broad, but we can get as specific as we need to get to fit your circumstances or desires.

What Are The Legal Requirements For An Advance Healthcare Directive In California?

You can’t have any decisions or directives that would promote an illegal action or promote illegality. For example, there are ongoing debates about physician-assisted suicide and euthanasia. Because these practices are unlawful, you can’t authorize somebody to end your life on your behalf.

As long as the directive is legal, you simply need to have mental capacity in order to sign or have the document witnessed and notarized at the time of its execution.

Which Key Elements Should I Include When Drafting An Advance Healthcare Directive?

The key elements to consider when drafting an advance healthcare directive are:

  • Who is going to be the designated agent?
  • What is the threshold for your capacity, and when would your agent take over?
  • Are there successive agents listed in case the primary agent is unavailable or unable to make those decisions?
  • What is your direction in terms of life-sustaining treatment?
  • What happens upon your passing to your remains?
  • Autopsy authority
  • Organ donation
  • Are you going to be buried or cremated, and who has the authority to manage that?
  • Is there going to be a conservator or conservatorship nomination?

Those are all factors that should be considered anytime you’re creating one of these directives.

Why Should I Have An Estate Planning Attorney Draft My Advance Healthcare Directive?

Estate planning attorneys have experience with drafting, execution, and follow-through with advance healthcare directives. There are a number of complications, conflicts, or other issues that can arise. The main issue is when you become legally incapacitated or meet the requirements of incapacity, whether it’s time for that designated agent to step in and make decisions for you.

There are many legal terms or a lot of information that should be included in directives that you may not know to include if you’re drafting a directive yourself. That’s particularly important with a document like this, where you’re essentially giving somebody else the power to determine whether or not to continue life-sustaining treatment.

For you, this is a serious decision and an essential document. With any legal document, I would always recommend that you take the extra step, even if it’s a little bit more expensive or time-consuming, to consult with an attorney.

It’s always better to be safe than sorry. If you prepare the directive yourself, you might forget to include something, or there may be a term that’s ambiguous that can create litigation.

Having an attorney prepare your healthcare directive for you with proper legal advice and guidance is always the first and best option.

Notes From The Field: Working With Clients With Conflicting Views About Their Healthcare Decisions

I have clients, especially couples, who set up estate plans together. One client may want to be buried; the other may want to be cremated. One client may want to donate organs on their passing if they’re viable. The other client may not want to donate organs. One client may want to have someone as their agent who has a background in medicine or the medical field, and the other person does not.

These are the types of conflicting decisions that arise fairly often. These are personal decisions. People don’t always agree on what the best course of action should be. However, if somebody is unsure about one of these key decisions, we never want to force them to choose the spot.

We want to ensure that if it’s information we can’t give them, they get that information or advice somewhere else before making a decision of this magnitude. I always recommend that someone get a second opinion. Maybe consult a medical professional. Maybe consult their family to make sure everyone is on the same page.

The client needs to make that decision only after:

  • They have sufficient time to work through those issues
  • We give them guidance on what we have seen before
  • They understand how a scenario practically plays out, not on paper, but in real life

Maybe we can guide them through that thought process, and they can come to a decision on their own. We’ve done that many times before. Only when a client has the information and the confidence to make a final decision would we recommend proceeding with executing or finalizing a document of that importance.

Still Have Questions? Ready To Get Started?

For more information on drafting an advance healthcare directive in Irvine, CA, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (949) 993-0639 today.

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