Nobody likes to think about a moment when they cannot speak for themselves. But planning for it is one of the kindest things you can do for your family. In California, the document that handles medical decisions during incapacity is the Advance Health Care Directive. It spares your loved ones from guessing what you would have wanted, and it gives your doctors clear instructions to follow.
This guide explains what the California Advance Health Care Directive covers, how it combines a living will with a health care power of attorney, and exactly how to complete and sign it.
What the directive is
The Advance Health Care Directive is California's official form for medical decision-making. It is set out in Probate Code Section 4700, which provides a statutory form you can fill in.1 One document does two jobs at once:
- Health care power of attorney. You appoint a person, your health care agent, to make medical decisions for you if you become unable to make them yourself.
- Individual health care instructions (a living will). You state your own wishes about life-sustaining treatment, pain relief, and end-of-life care, so your agent and doctors know what you want.
Because it combines both roles, the California directive replaces the older, separate documents some people still refer to as a durable power of attorney for health care and a living will.
Naming your health care agent
Your health care agent will speak for you in the hospital, so choose someone you trust to honor your wishes even under pressure. Pick a person who is calm, available, and able to advocate firmly with medical staff. You should also name at least one alternate in case your first choice is unavailable. California places one important limit: your treating health care provider, an employee of your health care institution, or the operator or employee of a community care facility generally cannot serve as your agent, unless they are a close relative.3
Stating your treatment wishes
The instructions section lets you say, in advance, how you want to be treated. You can direct that your life be prolonged as long as possible, or that treatment be withheld or withdrawn if you have an incurable condition or are near the end of life. You can add wishes about pain management, artificial nutrition and hydration, organ donation, and even your primary physician. You are free to be as specific or as general as you like, and you can leave any part blank if you would rather your agent decide in the moment.
How to complete and sign it (witnesses or notary)
To be legally effective in California, an Advance Health Care Directive must be signed and dated by you, and then either acknowledged before a notary public or signed by two qualified adult witnesses.2 You need one or the other, not both.
California sets rules on who may witness. A witness cannot be your appointed health care agent, and at least one of your two witnesses must not be related to you by blood, marriage, or adoption, and must not stand to inherit from your estate.3 If you live in a skilled nursing facility, an additional patient-advocate witness is required. These rules exist to guard against pressure or undue influence.
Changing or revoking it
You can revoke or replace your directive at any time while you have capacity. You revoke the agent designation by a signed writing or by personally informing your health care provider, and you can revoke your treatment instructions in any manner that shows your intent.2 Signing a new directive that says so also revokes the old one. As with any planning document, review it after major life changes and make sure the people you named are still the right choices.
Where it fits in your plan
The Advance Health Care Directive is the medical half of incapacity planning; a durable power of attorney is the financial half. Neither replaces a will, which controls what happens to your property after death. A complete California plan usually has all three. Our guide to the California durable power of attorney covers the financial side, and when you are ready to record your property wishes, our guide on how to write a will in California and our California will builder walk you through it.
Frequently Asked Questions
Is an Advance Health Care Directive the same as a living will? The California directive includes a living will. It combines your treatment instructions with the appointment of a health care agent in a single statutory document.
Does a California directive need to be notarized? It must be either notarized or signed by two qualified witnesses. You choose one method; both are valid.
Who cannot be my health care agent? Your treating provider, an employee of your health facility, or a community care facility operator generally cannot serve unless they are a close relative.
Can I change my directive later? Yes. While you have capacity you can revoke or replace it at any time, and signing a new one revokes the old.
Sources
- 1California Probate Code Section 4700 (Advance Health Care Directive form) (leginfo.legislature.ca.gov)
- 2California Probate Code Section 4673 (execution and revocation requirements) (leginfo.legislature.ca.gov)
- 3California Probate Code Section 4674 (witness eligibility) (leginfo.legislature.ca.gov)
- 4California Courts Self-Help: Wills and life planning (selfhelp.courts.ca.gov)
About the author
Max Kuch
Max Kuch writes about estate planning, wills and inheritance for California Will Template. He gathers the rules from the California statutes and the leading public data, then explains them in plain, accessible language so anyone can put their wishes in writing.