![Hawaii Advance Directive Form [PDF]](/_next/image?url=%2Fimages%2Fdocuments%2Fadvance-directive-general.png&w=3840&q=75)
Under Hawaii law, an advance directive for health care refers to the principal's instructions regarding their health care decisions—covering any care, treatment, service, or procedure that impacts their physical or mental condition—similar to a living will in the event of permanent incapacitation.
Additionally, the term “health care advance directive” is often aligned with a power of attorney (POA) for health care (medical power of attorney). This POA is a specific type of durable power of attorney in which an individual designates an agent to make health care decisions on their behalf when they cannot do so themselves.
Signing Requirements for Hawaii Advance Health Care Directive
The signing requirements for an advance directive form include specific provisions regarding both individual instructions and powers of attorney for health care.
Section 327E-3(a) of the Hawaii Revised Statutes states that individual instructions can be given orally or in writing. This section also allows individuals to specify that their instructions will take effect only upon the occurrence of a particular condition, such as becoming incapacitated or unable to communicate their wishes.
Signing Requirements for Hawaii
For a power of attorney for health care to be valid, it must meet the following criteria:
The power of attorney must be in writing and include the date of execution.
The principal must sign the document.
The signing of the document must be witnessed in one of the following ways:
At least two individuals must witness either the principal signing the document or the principal acknowledging their signature.
The document may be acknowledged before a notary public anywhere within the state.
Additionally, Section 327E-3(3) states that the following individuals cannot serve as witnesses for power of attorney for health care:
Health care providers. Witnesses cannot be health care providers or employees of a health care provider or facility.
Agent. The designated agent cannot serve as a witness.
Only related witnesses. At least one witness must not be related to the principal by blood, marriage, or adoption, nor entitled to any portion of the principal's estate upon their death, as per any existing will or legal stipulation.
Hawaii Advance Health Care Directive Revocation & Changing
The Hawaii advance directive becomes effective when the principal is determined to be incapacitated, meaning they are no longer able to make decisions on their own, according to Section 327E-3 (e). The primary physician determines that the principal lacks capacity.
As stated in Section 327E-4, a principal can revoke an advance directive for health care in several ways, such as:
Directive Revocation and Changes
The principal may revoke the designation of their agent by signing a written statement or personally informing their health care provider about it.
They may revoke all or part of their health care advance directive at any time, whether through writing or verbally.
If the principal goes through a divorce or legal separation, the designation of their spouse as agent is automatically revoked unless otherwise stated in the divorce decree or in the medical power of attorney.
If the principal creates a new advance directive that conflicts with an earlier one, the new advance directive will revoke the older one.
Additional Legal Considerations for Hawaii Advance Health Care Directive
According to Section 327E-5, if the principal hasn’t designated an agent, or if the agent is not available, a principal can choose their surrogate who can make health care decisions on the principal’s behalf. Additionally, if the patient has not specified anyone, a surrogate can be appointed by a close relative, such as a spouse, parent, or another close family member.
A surrogate can make most health care decisions for patients who can’t decide for themselves. However, when it comes to certain treatments like artificial nutrition or hydration, the surrogate cannot make a decision to withhold or withdraw these unless two doctors certify that continuing the treatment would only prolong the act of dying.
As specified in Section 327E-8, an agent has the same rights as the principal to access their medical information so they can request, review, and share the patient’s health care records. A copy of a written advance directive form or any changes to it is just as valid as the original document.
How to Choose a Health Care Agent in Hawaii
When selecting a health care agent in Hawaii, the most important thing is to choose someone who is trustworthy. The Hawaii health care proxy must be at least 18 years old and capable of acting in the principal’s best interests. They should be ready to act under pressure, understand the principal’s medical preferences, and be willing to advocate for them.
A health care agent is commonly a family member, close friend, or attorney. On the other hand, a principal’s health care provider or employees of the facility where the principal receives care cannot act as an agent.
What Happens if You Don’t Have an Advance Directive in Hawaii?
Without an advance directive for health care, if a specific event occurs that leaves you incapacitated and unable to make decisions, your medical care will be determined by your family, close friends, or an appointed guardian.
Their decision may be based on their opinions and the doctor's assessments of what is best for your condition rather than your personal wishes. This situation emphasizes the importance of creating an advance directive as part of your advance care planning.
By having an advance directive in place, you can be confident that your medical preferences are clearly stated and will be respected.