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Advance Directives
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Your Right To Make Decisions About Medical Treatment
You have the right to give instruction about your own health care and to name someone else to make health care decisions for you.
Planning in advance for health care decisions is the best way to insure that your choices will be known and your wishes will be respected. An advance health care directive is a written statement to let your doctor, family, and others know how you would want to be treated if you became unable to tell them. The advance health care directive names those individuals you have appointed as agents and empowers them to communicate with your doctors and other medical staff so your health care wishes can be carried out.
Download:
- Advance Directive Form E-1 (159kb)
Frequently Asked Questions About Advance Directives
Who decides about my treatment?
How do I know what I want?
Can other people help with my decisions?
Who can I name as my agent?
Can I choose a relative or friend to make healthcare decisions for me?
Do I have to wait until I am sick to express my wishes about health care?
Who can make an advance directive?
When does my agent begin making my medical decisions?
How does my agent know what I would want?
What if I do not have a family or friends who can be my agent?
What if I don't want to name an agent?
What if I change my mind?
What happens when someone else makes decisions about my treatment?
Will I still be treated if I don't make an advance directive?
How can I get more information about making an advance directive?
Who decides about my treatment?
Your doctors will give you information and advice about treatment. You have the right
to choose. You can say "Yes" to treatments you want. You can say "No" to any
treatment that you don't want — even if the treatment might keep you alive longer.
How do I know what I want?
Your doctor must tell you about your medical condition and about what different
treatments and pain management alternatives can do for you. Many treatments have
"side effects". Your doctor must offer you information about problems that medical
treatment is likely to cause you.
Often, more than one treatment might help you — and people have different ideas
about which is best. Your doctor can tell you which treatments are available to you, but
your doctor can't choose for you. That choice is yours to make and depends on what is
important to you.
Can other people help with my decisions?
Yes. Patients often turn to their relatives and close friends for help in making medical
decisions. These people can help you think about the choices you face. You can ask the
doctors and nurses to talk with your relatives and friends. They can ask the doctors and
nurses questions for you.
Who can I name as my agent?
You can choose any adult that you trust to speak for you when health care decisions must be made.
Can I choose a relative or friend to make healthcare decisions for me?
Yes. This person is called the agent. Family, friends, and domestic partners are the people you name as agents in your advance health care directive. It is helpful to talk to these people about your decisions before appointing them as agents. It is an opportunity to make sure the person you are choosing as your agent is able to respect your wishes and not have personal beliefs or emotions that prevent him or her from carrying out the agents responsibilities.
Do I have to wait until I am sick to express my wishes about health care?
No. In fact, it is better to choose before you get very sick or have to go into a hospital,
nursing home, or other healthcare facility. You can use an Advance Health Care
Directive to say who you want to speak for you and what kind of treatments you want.
These documents are called "advance" because you prepare one before healthcare
decisions need to be made. They are called "directives" because they state who will
speak on your behalf and what should be done.
In California, the part of an advance directive you can use to appoint an agent to make
healthcare decisions is called a Power of Attorney For Health Care. The part where
you can express what you want done is called an Individual Health Care Instruction.
Who can make an advance directive?
You can if you are 18 years or older and are capable of making your own medical
decisions. You do not need a lawyer.
When does my agent begin making my medical decisions?
Usually a health care agent will make decisions only after you lose the ability to make them yourself. This can be a permanent state or a temporary condition. You can also state in the Advance Health Care Directive if you want the agent to begin making decisions immediately.
If you become too sick to make your decisions, the agent can step in at that point and make decisions for you. That's why it is helpful if you can say in advance what you want to happen and select an agent before you are in a medical situation that requires this action.
How does my agent know what I would want?
After you choose your agent, talk to that person about what you want. Sometimes
treatment decisions are hard to make, and it truly helps if your agent knows what you
want. You can also write your wishes down in your advance directive.
It is best to talk to your agent periodically about your current health status and the choices you have or may be facing in the future. Get educated about your own health issues and the treatments or procedures that may be offered to you. As your health changes, review if the decisions you made in your Advance Health Care Directive still reflect your wishes and discuss them with the agent If you have different instructions about your health care, discuss these with the agent and revise your advance health care directive to state these new decisions.
What if I do not have a family or friends who can be my agent?
If you do not have family, friends, or others in your life who can be your agent, professionals are available to provide this service for a fee. In most communities a professional geriatric care manager is available through older adult service agencies and businesses as well as private individuals who are qualified to fulfill the role of agent for the advance health care directive.
What if I don't want to name an agent?
You can still write out your wishes in your advance directive, without naming an agent.
You can say that you want to have your life continued as long as possible. Or you can
say that you would not want treatment to continue your life. Also, you can express your
wishes about the use of pain relief or any other type of medical treatment.
Even if you have not filled out a written Individual Health Care Instruction, you
can discuss your wishes with your doctor, and ask your doctor to list those wishes in your
medical record. Or you can discuss your wishes with your family members or friends.
But it will probably be easier to follow your wishes if you write them down.
What if I change my mind?
You can change or cancel your advance directive at any time as long as you can
communicate your wishes. To change the person you want to make your healthcare
decisions, you must sign a statement or tell the doctor in charge of your care.
What happens when someone else makes decisions about my treatment?
The same rules apply to anyone who makes healthcare decisions on your behalf such as a health care agent or a person appointed by a court to make decisions for you. All are required to follow your Health Care Instructions or, if none, your general wishes about treatment, including stopping treatment. If your treatment wishes are not known, the surrogate must try to determine what is in your best interest.
The people providing your health care must follow the decisions of your agent or surrogate unless a requested treatment would be bad medical practice or ineffective in helping you. If this causes disagreement that cannot be worked out, the provider must make a reasonable effort to find another healthcare provider to take over your treatment.
Will I still be treated if I don't make an advance directive?
Absolutely. You will still get medical treatment. We just want you to know that if you
become too sick to make decisions, someone else will have to make them for you.
Remember that:
- A Power of Attorney For Health Care lets you name an agent to make decisions for you. Your agent can make most medical decisions — not just those about life sustaining treatment — when you can't speak for yourself. You can also let your agent make decisions earlier, if you wish.
- You can create an Individual Healthcare Instruction by writing down your wishes about health care or by talking with your doctor and asking the doctor to record your wishes in your medical file. If you know when you would or would not want certain types of treatment, an Instruction provides a good way to make your wishes clear to your doctor and to anyone else who may be involved in deciding about treatment on your behalf.
- These two types of Advance Healthcare Directives may be used together or separately.
To implement Public Law 101-508, the California Consortium on Patient Self-Determination prepared this brochure in 1991; it was revised in 2000 by the California Department of Health services, with input from members of the consortium and other interested parties, to reflect changes in state law.
How can I get more information about making an advance directive?
Ask your doctor, nurse, social worker, or healthcare provider to get more
information for you. You can have a lawyer write an advance directive for
you, or you can complete an advance directive E-1 form provided by the
hospital or by downloading the E-1 form as provided below.
Click Here to download the Advance Directives Form E-1.
(159k PDF File*)
* Adobe Acrobat Reader is required to view these documents.
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