This page explains your right to make health care decisions and
how you can plan now for your medical care if you are unable to
speak for yourself in the future. We hope this information will
help increase your control over your medical treatment. (A
federal law requires us to give you this information.)
Who decides 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
do not 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 alterations 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 cannot
choose for you. That choice is your 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.
Can I choose a relative or friend to make health care decisions
Yes. You may tell your doctor that you want someone else to make
health care decisions for you. Ask the doctor to list that person
as your health care "surrogate" in your medical record. The
surrogate's control over your medical decisions is effective only
during treatment for your current illness or injury, or if you
are in a medical facility, until you leave the facility.
What if I become too sick to make my own health care decisions?
If you have not named a surrogate, your doctor will ask your
closest available relative or friend to help decide what is the
best for you. Most of the time that works. But sometimes everyone
does not agree about what to do. That is why it is helpful if you
can say in advance what you want to happen if you cannot speak
Do I have to wait until I am sick to express my wishes about
No. In fact, it is better to choose before you get very sick or
have to go into a hospital, nursing home, or other health care
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 health care
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 health care 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 of age or older and are capable of
making your own medical decisions. You do not need a lawyer.
Who can I name my agent?
You can choose an adult relative or any other person you trust to
speak for you when medical decisions must be made. 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. But, if you wish, you can state in the Power of
Attorney for Health Care that you want the agent to begin making
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 decisions down in your advance directive.
What if I do not 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 you 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 communicate your
wishes. To change the person you want to make your health care
decisions, you must sign a statement or tell the doctor in charge
of your care.
What happens when someone else makes decisions about my
The same rules apply to anyone who makes health care decisions on
your behalf-a health care agent, a surrogate whose name you gave
the doctor, or a person appointed by a court to make decisions
for you. All are required to follow your Health Care Instructions
or, if none, 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 health care provider to
take over your treatment.
Will I still be treated if I do not make an Advance Directive?
Absolutely. You will 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.
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
cannot speak for yourself. You can also let your agent make
decisions earlier, if you wish.
You can create an Individual Health Care 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 Health Care Directives may be used together or