Advance Health Care Directives
What is an Advance Health Care Directive?
An Advance Health Care Directive is a legal document that does two things. It lets you name someone to make health care decisions on your behalf if you become unable to make them yourself, and it lets you write down your wishes about the medical treatment you do and don't want.
In California, the Advance Health Care Directive replaced the older Durable Power of Attorney for Health Care and the Natural Death Act Declaration. A single document now covers both roles.
Why do I need one?
Because if you can't communicate and no one has authority to speak for you, decisions about your care may be delayed, or made by someone you would not have chosen.
Without a directive, your family may have to petition a court to be appointed as your conservator before they can act. That process takes time, costs money, and happens in public — at exactly the moment your family least needs the burden.
An Advance Health Care Directive avoids all of that. It also spares the people you love from guessing at what you would have wanted.
Who should I name as my agent?
Your agent should be someone you trust to follow your wishes, and someone able to make difficult decisions under pressure. That is not always the person closest to you — it needs to be someone who can hold firm in a hospital corridor.
You can name alternates in case your first choice is unavailable or unwilling to serve when the time comes. We usually recommend naming at least one.
Under California law, your agent generally cannot be your supervising health care provider, or an employee of the facility where you are receiving care, unless that person is a relative.
What decisions can my agent make?
Unless you limit their authority, your agent can consent to or refuse medical treatment, choose your doctors and care facilities, access your medical records, and make decisions about pain relief.
You decide the scope. You can give your agent broad authority, or restrict it to particular decisions, and you can specify when their authority begins — immediately, or only once a doctor determines you cannot make your own decisions.
What if I have strong views about end-of-life care?
You can write them into the directive. Many people include instructions about life-sustaining treatment, artificial nutrition and hydration, and pain management.
You can also record decisions about organ donation and, if you wish, your preferences for the disposition of your remains.
The more specific you are, the less weight your agent has to carry alone.
Does it need to be witnessed or notarized?
California requires either two qualified witnesses or a notary. Botz Cody Law provides witnessing and notarization as part of your estate plan, at no additional charge.
There are restrictions on who may serve as a witness. Your agent cannot witness the document, and at least one witness must not be related to you by blood, marriage, or adoption, and must not be entitled to any part of your estate.
Can I change it later?
Yes. You can revoke or replace your directive at any time while you have capacity. If you name your spouse as your agent and you later divorce, the designation is generally revoked automatically by law — but a new document should be prepared rather than relying on that.
We recommend reviewing your directive whenever your circumstances change: a marriage, a divorce, a death in the family, a serious diagnosis, or a move to another state.
Who should have a copy?
Your agent and any alternates, your primary physician, and any hospital or care facility where you are being treated. A directive nobody can find when it's needed does no good at all.
We provide copies as part of your estate plan and can discuss how to make sure they reach the right people.
How does this fit with the rest of my estate plan?
An Advance Health Care Directive covers medical decisions. A Durable Power of Attorney covers financial ones. A living trust handles your property. Each does a different job, and most people need all three.
The Advance Health Care Directive is included in every full estate plan we prepare.
See our Fees page for details, or contact us to arrange a free initial consultation.