Help Making Medical Decisions
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 for me?
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 for yourself.
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 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 decisions immediately.
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 treatment?
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.
Remember ...
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 separately.
The California Consortium on Patient Self-Determination prepared the preceding text, which has been adopted by the California Department of Health Services to implement Public Law 101-508, 4/97