Advanced Health Care Directives

Empowering Patients and Respecting Their Health Care Decisions

Advance Directives Regarding Your Health Care
Oroville Hospital encourages you to make your wishes about your medical care known. It is our policy, in accordance with state and federal law, to respect a competent adult patient’s right to make his or her own health care decisions.

In order to know the options and decide what is right for you, we encourage you to talk with your doctor, your family and your friends.

Upon admission, you will receive a brochure, “Your Right to make Decisions about Medical Treatment”. The brochure explains your rights to make health care decisions and how you can plan what should be done if you are unable to speak for yourself.

FAQ’s
To help you understand your right to express your decisions about medical treatment, we have prepared the following answers to frequently asked questions about advance health care directives based on information from the California Coalition for Compassionate Care and the California Consortium on Patient Self-Determination.

How do I know what I want? 
Your doctor must tell you about your medical condition and about what different treatments can do for you. Many treatments have "side effects." Your doctor must offer you information about serious 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 can't choose for you. That choice depends on what is important to you.

What if I'm too sick to decide?
If you can't make treatment decisions, your doctor will ask your closest available relative or friend to help decide what is best for you. In some rare instances everyone will not agree on a decision. That is why it is helpful if you say in advance what you want to happen if you can't speak for yourself. There is a new flexible advance directive form called the advance health care directive form that you can use to say what you want and who you want to speak for you.

This form can serve either one (or both) of the following two functions:

• Power of Attorney for Health Care - to appoint an agent or "surrogate."
• Instructions for Health Care - to indicate your wishes.

Who can fill out this form?
You can if you are 18 years or older and of sound mind. You do not need a lawyer to fill it out.

If I have a previous advance directive form is it still legal?
Yes. If you have already completed an advance directive form that was valid before July 1, 2000, it is still valid now. This includes the Durable Power of Attorney for Health Care, the Natural Death Act Declaration and the Pre-Hospital Do-Not-Resuscitate forms. You do not have to change any of these forms if you choose not to.

Who can I name to make medical treatment decisions when I'm unable to do so?
You can choose an adult relative or friend you trust as your "agent" to speak for you when you're too sick to make your own decisions. The most appropriate decision-maker is the one with whom you have a close, caring relationship, and is aware of your values and beliefs, and is willing and able to make the needed decisions.

My "values and beliefs?" But I haven't talked with anyone about these!
That's why it is a good idea to talk with family or close friends about the things that are important to you regarding quality of life and how you would want to spend your last days and weeks. Knowing the things that are most important to you will help your loved ones make the best decisions possible on your behalf. If your agent doesn't know your wishes, then he or she will decide based on what is in your best interest.

What if I don't want to appoint an agent? Or don't have one to appoint?
You do not have to appoint an agent. You can still complete the Instructions for Health Care and this will provide your doctors with information to guide your care.

What kinds of things can I write in my instructions for Health Care?
You can, if you wish, write your preferences about accepting or refusing life-sustaining treatment (like CPR, feeding tubes, breathing machines), receiving pain medication, making organ donations, indicating your main doctor for providing your care or other things that express your wishes and values.

If I appoint an agent, what can that person do? 
Your agent will make all decisions for you, just like you would if you could. Your agent can choose your doctor and where you will receive your care, speak with your health care team, review your medical record and authorize its release, accept or refuse all medical treatments and make arrangements for you when you die. You should instruct your agent on these matters so he or she knows how to decide for you. The more you tell him or her the better he or she will be able to make those decisions on your behalf.

When does my agent make decisions for me? 
Usually the agent makes decisions only if you are unable to make them yourself - such as, if you've lost the ability to understand things or communicate clearly. However, if you want, your agent can speak on your behalf at any time, even when you are still capable of making your own decisions. You can also appoint a "temporary" agent - for example, if you suddenly become ill, you can tell your doctor if there is someone else you want to make decisions for you. This oral instruction is just as legal as a written one!

Do I have to fill out one of these forms?
No, you don't have to fill out any of these forms if you don't want to. Furthermore, you can make an individual health care instruction orally to any person and it is considered valid. All health care providers must document your wishes in your medical record. But it is often easier to follow your instructions if they are written down.

Can I make up my own form or use one from another state?
Yes. Any type of form is legal as long as it has at least three things: 1) your signature and date, 2) the signature of two qualified witnesses, and 3) if you reside in a skilled nursing facility, the signature of the patient advocate or ombudsman. These signatures however must include special wording.

Will I still be treated if I don't fill out these forms?
Absolutely. You will still 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.

Sounds difficult. Do I need an attorney to help with this?
No. Completing an advance health care directive isn't difficult and an attorney is not necessary. But actually the most important part of this is talking to your loved ones.

Without that conversation, the best form in the world may not be helpful.
What if I change my mind?
You can change or revoke your advance directive form or oral instructions that you may have given to your health care providers at any time.

How can I get more information about advance directives? 
Ask your doctor or nurse, or call Oroville Hospital's Utilization Management Department at 532-8105. Our patient services staff will be happy to provide you with appropriate forms.

Advance Health Care Directive Forms
Advance Health Care Directive Form – English language form in Adobe Acrobat Reader format (PDF) 39 kb.
Formulario de Directiva por Anticipado de la Atención de la Salud – Spanish language form in Adobe Acrobat Reader format (PDF) 40 kb.

These files are in Adobe Acrobat Reader (PDF) format. To view and print Advance Health Care Directive forms, you will need Adobe Acrobat Reader. If this program is not installed on your computer, please visit the Adobe download site for Free Adobe Acrobat Reader Software.