-- Last revised 01/23/24 --
Health Care Decisions for Adults Without Decisionmaking Capacity - Study L-4000
The Commission's recommendation proposes a new Health Care
Decisions Law to consolidate the Natural Death Act and the statutes governing
the durable power of attorney for health care, and provide comprehensive
rules relating to health care decisionmaking for incapacitated adults.
The proposed law, drawing heavily from the Uniform Health-Care Decisions
Act (1993), includes new rules governing individual health care
instructions, and provides a new optional statutory form of an advance
health care directive.
The guiding principle of the bill enacting the Commission's
recommendation is to effectuate the stated desires of the patient, as set out
in an advance directive or, in the absence of an advance directive, as expressed
to authorized surrogate decisionmakers. If the patient has not made his or her
wishes known, health care decisions are to be made in the patient's best interest,
as determined by the appropriate surrogate decisionmaker, taking into account the
patient's personal values known to the surrogate. The Health
Care Decisions Law is intended to fulfill the incapacitated patient's
desires and best interest without resort to judicial proceedings, except
as a last resort.
The bill also codifies a number of duties of health care
providers and institutions to comply with health care instructions, and
to keep records relating to capacity determinations, surrogates, and
instructions. In addition, existing limitations on the authority of
agents, witnessing requirements, and the prohibition on mercy killing
and euthanasia, are continued in the new law.
Conforming changes in the procedure for obtaining court
authorization for medical treatment make clear that courts in
proper cases have the same authority as other surrogates to make health
care decisions, including withholding or withdrawal of life-sustaining
treatment. Similarly, the statute governing decisionmaking by
conservators for patients who have been adjudicated to lack the capacity
to make health care decisions are conformed to the standards governing
other health care surrogates.
The bill unifies the standards governing health care
decisionmaking for adults without decisionmaking capacity so that the
same rules apply whether the surrogate decisionmaker is (1) an agent
named in the patient's advance directive, (2) a family member or friend
acting as a surrogate decisionmaker, (3) a public guardian, or (4) a
court making health care decisions as a last resort.
The Commission's original recommendation, which is embodied
in the bill as introduced, included two important additional elements:
(1) a "family consent" statute (proposed Prob. Code § 4710 et seq.),
and (2) a surrogate committee procedure for making necessary health care
decisions where the patient does not have an agent, conservator, or
other health care surrogate (proposed Prob. Code § 4720 et seq. ).
At the suggestion of the Assembly Judiciary Committee staff, the Commission
agreed to remove these procedures for additional study.
Related Material
- Legislation
- Final Recommendation
- Tentative Recommendation
- Staff Memoranda
- Subscribe to Receive Notice of New Materials
Legislation
-
1999: Assembly Bill 891 (Alquist)
Enacted. 1999 Cal. Stat. ch. 658
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Final Recommendation
- Report -- 2000 Health Care Decisions Law & Revised Power of Attorney Law (3/1/2000)
- Recommendation -- Health Care Decisions for Adults Without Decisionmaking Capacity (12/11/98)
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Tentative Recommendations and Other Requests for Comment
- Tentative Rec. -- Health Care Decisions for Incapacitated Adults (June 1998)
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Staff Memoranda
- Memo 2000-62, Supp. 3 -- Family Consent in Health Care Decisionmaking for Adults (Materials subscribeted for October 2000 Meeting) (10/5/2000)
- Memo 2000-62, Supp. 2 -- Family Consent in Health Care Decisionmaking for Adults (Additional Commentary) (10/4/2000)
- Memo 2000-62, Supp. 1 -- Family Consent in Health Care Decisionmaking for Adults (Additional Commentary) (10/3/2000)
- Memo 2000-62 -- Family Consent in Health Care Decisionmaking for Adults (Revised Draft Statute) (9/15/2000)
- Memo 2000-49 -- Family Consent in Health Care Decisionmaking for Adults (7/10/2000)
- Memo 2000-5, Supp. 1 -- Family Consent in Health Care Decisionmaking for Adults (Comments from Dr. Orr) (2/7/2000)
- Memo 2000-5 -- Family Consent in Health Care Decisionmaking for Adults (2/3/2000)
- Memo 99-82, Supp. 2 -- Family Consent in Health Care Decisionmaking for Adults: Additional Comments (11/29/1999)
- Memo 99-82, Supp. 1 -- Family Consent in Health Care Decisionmaking for Adults: Domestic Partners (11/24/1999)
- Memo 99-82 -- Family Consent in Health Care Decisionmaking for Adults (10/29/1999)
- Memo 99-61, Supp. 1 -- Family Consent in Health Care Decisionmaking: West Virginia Experience (10/12/1999)
- Memo 99-61 -- Family Consent in Health Care Decisionmaking (10/6/1999)
- Memo 99-39 -- Surrogate Committee in Health Care Decisionmaking (10/6/1999)
- Memo 99-38 -- 1999 Legislative Program: AB 891 - Health Care Decisions (6/17/1999)
- Memo 98-74, Supp. 3 -- Health Care Decisions: Draft Recommendation Revisions (Comments of Harley Spitler) (12/8/1998)
- Memo 98-74, Supp. 2 -- Health Care Decisions: Draft Recommendation Revisions (Comments of State Bar Advance Directives Committee) (12/7/1998)
- Memo 98-74, Supp. 1 -- Health Care Decisions: Draft Recommendation Revisions (Preliminary Part) (12/4/1998)
- Memo 98-63, Supp. 1 -- Health Care Decisions: Comments on Tentative Recommendation (Prof. English Comments) (11/30/1998)
- Memo 98-74 -- Health Care Decisions: Draft Recommendation Revisions (11/23/1998)
- Memo 98-63 -- Health Care Decisions: Comments on Tentative Recommendation (9/18/1998)
- Memo 98-28, Supp. 1 -- Health Care Decisions: Staff Draft Tentative Recommendation (Additional Comment) (4/22/1998)
- Memo 98-28 -- Health Care Decisions: Staff Draft Tentative Recommendation (4/15/1998)
- Memo 98-16, Supp. 3 -- Health Care Decisions: Staff Draft Tentative Recommendation (Comments of Dr. Orr) (3/18/1998)
- Memo 98-16, Supp. 2 -- Health Care Decisions: Staff Draft Tentative Recommendation (Conforming Revisions) (3/6/1998)
- Memo 98-16, Supp. 1 -- Health Care Decisions: Staff Draft Tentative Recommendation (Preliminary Part initial draft) (3/13/1998)
- Memo 98-16 -- Health Care Decisions: Staff Draft Tentative Recommendation (3/2/1998)
- Memo 97-75 -- Health Care Decisions: Staff Draft Statute (11/4/1997)
- Memo 97-63 -- Health Care Decisions: Statutory Surrogacy (9/4/1997)
- Memo 97-60 -- Health Care Decisions: Revised Staff Draft (Incorporating Uniform Health Care Decisions Act into Probate Code) (9/2/1997)
- Memo 97-41 -- Health Care Decisions: Staff Draft (Incorporating Uniform Health-Care Decisions Act into Probate Code) (6/5/1997)
- Memo 97-4 -- Health Care Decisions: Uniform Health-Care Decisions Act (Introduction, Advance Health-Care Directives, Miscellaneous Provisions) (3/27/1997)
- Memo 96-66 -- Health Care Decisions: Natural Death Act (10/4/1996)
- Memo 96-39, Supp. 1 -- Health Care Decisions: Selected Issues (Hoffman Comments) (7/10/1996)
- Memo 96-39 -- Health Care Decisions: Selected Issues (Natural Death Act, Statutory Surrogacy, Execution Formalities) (7/2/1996)
- Memo 96-34, Supp. 1 -- Health Care Decisions: Preliminary Considerations (CMA Letter) (5/3/1996)
- Memo 96-34 -- Health Care Decisions: Preliminary Considerations (5/3/1996)