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Advance Directive for Health Care Form - Hawaii
The Hawaii Advance Health Care Directive Form is a revisable set of written instructions about future medical care that take effect in cases when a patient becomes unable to make decisions for themselves. The purpose of the form is to let an individual plan their medical treatment in advance. The form lists decisions on life-sustaining medical procedures and about the specific kinds of treatment the individual may or may not wish to receive and can be used to elect a spouse, relative, friend or attorney as a decision-maker in case the individual is unable to make their own decisions because of an illness, accident or incapacity.
This Advance Directive was prepared by the Hawaii State Department of Health and is available for download below. The main difference between this form and a Hawaii Living Will is that a Living Will - also called a "directive to physicians" - is one form of Advance Health Care Directive. It's more limited in nature and only state a patient's wishes for end-of-life medical care.
A Hawaii Advance Directive is defined by § 327E-2 of Chapter 327E (Uniform Health-Care Decisions Act) . The document must be signed by two (2) witnesses. A health-care provider, an employee of a health-care provider or the agent may not be witnesses.
What Is a Hawaii Advance Directive?
An Advance Directive is a written form that lists an individual's preferences for medical care and grants a spouse, child, family member, friend or attorney the authority to make decisions regarding health care on the individual's behalf. The document includes two separate parts:
- A Medical Power of Attorney - also known as a Health Care Power of Attorney or a Health Care Proxy - in which the individual elects a person to make medical decisions when they are unable to do so due to being terminally ill, seriously injured, in a coma or near the end of life.
- A Living Will - a written, legal document that lists an individual's wishes regarding life-sustaining procedures, pain management or organ donation that takes effect when the patient is terminally ill.
How to Write an Advance Directive in Hawaii?
Making an Advance Care Directive in Hawaii usually features the following steps:
STEP 1 - Elect a health care proxy - or agent - to make medical decisions on your behalf. Be sure to choose a person willing to respect and follow your wishes
STEP 2 - Write down your wishes regarding any limitations in medical treatment. Specify whether you agree to be on a dialysis machine, extracorporeal membrane oxygenation (ECMO) machine, receive CPR or take antibiotics to treat infections
STEP 3 - Make decisions regarding the possibility of organ and tissue donation and state your preferences regarding burial and the disposition of remains.
STEP 4 - Keep the original signed and certified form, hand a copy out to your agent and ask your doctor to keep a copy of your document with your medical records.
Download Advance Directive for Health Care Form - Hawaii
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