Encinitas,
San Diego County
Practice Areas - Advance Health Care Directive
            

What is an Advance Health Care Directive (AHCD)? 

An Advance Health Care Directive, sometimes referred to as a Health Directive or Advance Medical Directive, provides instructions for what to do in situations where a person needs medical treatment or personal care but is incapacitated (mentally or physically) and is no longer able to communicate those choices or decisions for themselves.  When creating an Advance Health Care Directive people will also appoint Health Care Agents (typically family members or close friends) to assist them with carrying out their Health Care and Personal Care wishes.

 

Why do I need an Advance Health Care Directive? 

An Advance Health Care Directive is an essential piece of any Estate Plan.  An Advance Health Care Directive lets you take control of what happens to you when you are no longer able to communicate your wishes.  Without an Advance Health Care Directive prolonged suffering could occur because of the receipt of unwanted treatment, or on the contrary, desired treatment may be withheld.  The indecision, guessing, stress and potential conflict between remaining family can be eliminated or significantly reduced if you have already provided instructions.  The well-known Terri Schiavo case from Florida illustrates how a bad situation got worse when an incapacitated woman’s parents and surviving spouse had competing beliefs about what Mrs. Schiavo would have wanted. 

 

What if I already have a Living Will? 

Having a Living Will is much better than having nothing at all, but an Advance Health Care Directive is more comprehensive than most Living Wills.  Typically a Living Will provides instructions for health care providers for when you are no longer able to do so yourself but does not appoint Health Care Agents to carry out those instructions.  Living Wills tend to focus on a narrow set of circumstances, primarily end of life decisions. 

Are there advantages of having an Advance Health Care Directive?

Some Advance Health Care Directives can provide instructions beyond end of life decisions.  For example, Personal Care issues may be addressed such as a person's wish to remain in their own home as long as it is safe and financially feasible.  Most Living Wills do not address this issue.  Also, the Advance Health Care Directive provides the opportunity to appoint Health Care Agents.  Appointing Health Care Agents helps you ensure there will be somebody to assist you in carrying out your wishes.  You will not have to hope for the best and rely on a hospital or whomever's care you are in to follow your wishes.

 

By creating an Advance Health Care Directive am I giving up control over my life? 

No.  A competent adult cannot be forced against his or her will to accept or reject medical treatment.  Also, an Advance Health Care Directive can be amended or revoked at any time, so long as its creator is still competent.   

 

Will the Doctors follow my instructions? 

Doctors should follow your Advance Health Care Directive if your instructions do not request the violation of any laws and you have Health Care Agents in place to assist with the carrying out of your wishes.  Your Health Care Agents can be given the authority to transfer you to a different health care provider that will honor your wishes and even bring suit against noncompliant Doctors.  One of the few reasons a Doctor may be justified in not honoring an Advance Health Care Directive is if there was not a HIPAA Release in place.  A key function of HIPAA (Health Insurance Portability Authorization Act) is to protect the privacy of patients.  It forbids Doctors from disclosing patient information.  It is critical to have an executed HIPAA Release to allow Doctors to work with the Health Care Agents you designate in your Advance Health Care Directive.


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