Section § 4650

Explanation

This law emphasizes that adults have the fundamental right to control their own health care decisions, which includes deciding whether to continue or stop life-sustaining treatment. It acknowledges modern technology's role in extending life, sometimes beyond natural limits, which can infringe on personal dignity and cause unnecessary suffering if the person is not expected to recover. The law also suggests that health care decisions should generally be made outside of court unless there's a dispute.

The Legislature finds the following:
(a)CA Probate Code § 4650(a) In recognition of the dignity and privacy a person has a right to expect, the law recognizes that an adult has the fundamental right to control the decisions relating to his or her own health care, including the decision to have life-sustaining treatment withheld or withdrawn.
(b)CA Probate Code § 4650(b) Modern medical technology has made possible the artificial prolongation of human life beyond natural limits. In the interest of protecting individual autonomy, this prolongation of the process of dying for a person for whom continued health care does not improve the prognosis for recovery may violate patient dignity and cause unnecessary pain and suffering, while providing nothing medically necessary or beneficial to the person.
(c)CA Probate Code § 4650(c) In the absence of controversy, a court is normally not the proper forum in which to make health care decisions, including decisions regarding life-sustaining treatment.

Section § 4651

Explanation

This section is about making health care decisions for adults who can't make these decisions themselves, due to a lack of capacity. The rules here don't change someone's right to decide on their own health care as long as they can. Also, it doesn't change the laws for health care emergencies or care for minors who aren't legally independent.

(a)CA Probate Code § 4651(a) Except as otherwise provided, this division applies to health care decisions for adults who lack capacity to make health care decisions for themselves.
(b)CA Probate Code § 4651(b) This division does not affect any of the following:
(1)CA Probate Code § 4651(b)(1) The right of an individual to make health care decisions while having the capacity to do so.
(2)CA Probate Code § 4651(b)(2) The law governing health care in an emergency.
(3)CA Probate Code § 4651(b)(3) The law governing health care for unemancipated minors.

Section § 4652

Explanation

This law says that it does not give anyone the power to agree to certain medical procedures for a patient, such as placing them in a mental health facility, electroshock therapy, brain surgery, sterilization, or abortion.

This division does not authorize consent to any of the following on behalf of a patient:
(a)CA Probate Code § 4652(a) Commitment to or placement in a mental health treatment facility.
(b)CA Probate Code § 4652(b) Convulsive treatment (as defined in Section 5325 of the Welfare and Institutions Code).
(c)CA Probate Code § 4652(c) Psychosurgery (as defined in Section 5325 of the Welfare and Institutions Code).
(d)CA Probate Code § 4652(d) Sterilization.
(e)CA Probate Code § 4652(e) Abortion.

Section § 4653

Explanation

This law makes it clear that nothing in this section supports mercy killing, assisted suicide, or euthanasia. The only actions allowed are letting a person die naturally by withholding or withdrawing medical care based on an advance health care directive or a decision made by a legally designated person.

Nothing in this division shall be construed to condone, authorize, or approve mercy killing, assisted suicide, or euthanasia. This division is not intended to permit any affirmative or deliberate act or omission to end life other than withholding or withdrawing health care pursuant to an advance health care directive, by a surrogate, or as otherwise provided, so as to permit the natural process of dying.

Section § 4654

Explanation

This law explains that health care providers and institutions are not required to go against generally accepted medical standards when providing care. In other words, they don't have to offer treatments or procedures that conflict with what is widely recognized as the proper medical practice.

This division does not authorize or require a health care provider or health care institution to provide health care contrary to generally accepted health care standards applicable to the health care provider or health care institution.

Section § 4655

Explanation

(a) This law states that if a person hasn't made or has canceled an advance directive (a legal document stating preferences for medical treatment), it shouldn't automatically be assumed what their medical care wishes are.

(b) Also, if a person has tried to commit suicide, that action shouldn't be used to conclude that they want to limit their health care options.

(a)CA Probate Code § 4655(a) This division does not create a presumption concerning the intention of a patient who has not made or who has revoked an advance health care directive.
(b)CA Probate Code § 4655(b) In making health care decisions under this division, a patient’s attempted suicide shall not be construed to indicate a desire of the patient that health care be restricted or inhibited.

Section § 4656

Explanation

This law states that if a person dies because their health care was withheld or withdrawn according to the rules in this division, it is not considered suicide or homicide. Additionally, this does not affect or cancel any life insurance policies or annuities that provide a death benefit, even if the policy says otherwise.

Death resulting from withholding or withdrawing health care in accordance with this division does not for any purpose constitute a suicide or homicide or legally impair or invalidate a policy of insurance or an annuity providing a death benefit, notwithstanding any term of the policy or annuity to the contrary.

Section § 4657

Explanation

This law assumes that a patient is able to make their own health care decisions, like creating or canceling an advance health care directive, and choosing or rejecting someone to make decisions for them. If someone thinks otherwise, they must prove it.

A patient is presumed to have the capacity to make a health care decision, to give or revoke an advance health care directive, and to designate or disqualify a surrogate. This presumption is a presumption affecting the burden of proof.

Section § 4658

Explanation

This law states that a primary physician is responsible for deciding if a patient can or cannot make their own health care decisions unless a written advance health care directive says otherwise. This includes determining if any condition affects the authority given to another person to make decisions on the patient's behalf.

Unless otherwise specified in a written advance health care directive, for the purposes of this division, a determination that a patient lacks or has recovered capacity, or that another condition exists that affects an individual health care instruction or the authority of an agent or surrogate, shall be made by the primary physician.

Section § 4659

Explanation

This law outlines who can and cannot make healthcare decisions on behalf of someone else through a power of attorney or as a health care surrogate. Generally, a patient's supervising health care provider, employees at the facility where they receive care, or operators of community care facilities cannot act as surrogates. However, exceptions are made for employees who are related to the patient or work at the same facility, excluding the supervising provider. Additionally, a conservator under certain mental health laws cannot be named as an agent unless specific conditions are met, including that the patient has legal representation and the lawyer certifies that the patient understands the implications of the directive.

(a)CA Probate Code § 4659(a) Except as provided in subdivision (b), none of the following persons may make health care decisions as an agent under a power of attorney for health care or a surrogate under this division:
(1)CA Probate Code § 4659(a)(1) The supervising health care provider or an employee of the health care institution where the patient is receiving care.
(2)CA Probate Code § 4659(a)(2) An operator or employee of a community care facility or residential care facility where the patient is receiving care.
(b)CA Probate Code § 4659(b) The prohibition in subdivision (a) does not apply to the following persons:
(1)CA Probate Code § 4659(b)(1) An employee, other than the supervising health care provider, who is related to the patient by blood, marriage, or adoption, or is a registered domestic partner of the patient.
(2)CA Probate Code § 4659(b)(2) An employee, other than the supervising health care provider, who is employed by the same health care institution, community care facility, or residential care facility for the elderly as the patient.
(c)CA Probate Code § 4659(c) A conservator under the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code) may not be designated as an agent or surrogate to make health care decisions by the conservatee, unless all of the following are satisfied:
(1)CA Probate Code § 4659(c)(1) The advance health care directive is otherwise valid.
(2)CA Probate Code § 4659(c)(2) The conservatee is represented by legal counsel.
(3)CA Probate Code § 4659(c)(3) The lawyer representing the conservatee signs a certificate stating in substance:
“I am a lawyer authorized to practice law in the state where this advance health care directive was executed, and the principal or patient was my client at the time this advance directive was executed. I have advised my client concerning his or her rights in connection with this advance directive and the applicable law and the consequences of signing or not signing this advance directive, and my client, after being so advised, has executed this advance directive.”

Section § 4660

Explanation

If you have a copy of a document related to your advance health care arrangements—like a directive about your medical wishes, a cancellation of that directive, or the name of someone who can make decisions for you—it’s just as valid as having the original document.

A copy of a written advance health care directive, revocation of an advance directive, or designation or disqualification of a surrogate has the same effect as the original.