What is an Advance Health Care Directive?
An Advance Health Care Directive (AHCD) is a written statement that sets out guidelines that you wish followed for your health care. It specifies another adult to make health care decisions for you in case you are unable to do so, and enables you to define the care and treatment you wish to have if you become incapacitated and unable to communicate your desires.

An AHCD enables individuals to present in a legally recognized document their desire to be cared for consistent with the theology and practice of Christian Science, and to refuse medical treatment. An AHCD can also help protect the person you have appointed to be your health care agent from liability for “failure to provide medical treatment” or “neglect” because he or she is following your written instructions. An AHCD must be signed either before a notary who swears that the signer appears to be of sound mind, and under no duress, fraud or undue influence, or before two witnesses who swear to the same oath.

Is an AHCD the same as a Durable Power of Attorney for Health Care? Is it the same as a living will?
Not really. Many people confuse these three documents because they do similar things. A Durable Power of Attorney for Health Care names an agent to make health care decisions for you if you cannot make the decisions yourself, and it gives your agent guidelines to follow in making those decisions. A living will states that you do not want any medical measures taken to prolong your life if you are diagnosed with a life-threatening injury or illness. An AHCD can do all that and more. Even if you don’t have anyone to name as an agent, you can still set out guidelines for your health care in an AHCD. Also, in an AHCD if you have someone to name as an agent, you can delegate to them immediately the ability to make decisions about your health care instead of waiting until you are no longer able to make the decisions yourself.

What is an agent?
An agent is someone you choose who steps into your shoes to make decisions for you. If you name an agent in an AHCD, you are giving them the authority to make decisions about your health care. Therefore, you will probably want to consider appointing an adult who is close to you who you know understands and supports your wishes with respect to health care and treatment. You are advised to talk with your proposed health care agent about your care and treatment desires before completing your AHCD.

What do I do if I have no one to name as an agent?
In an AHCD you do not need to name an agent. You can set out the guidelines for your health care without naming an agent.

Do I need an AHCD if I’m a Christian Scientist?
Yes. Even though you do not intend to seek medical care, you might find yourself in a medical situation. It is important for Christian Scientists to have such a document in effect prior to the time of need. Health care providers such as paramedics, ambulance attendants, and hospital staff are more likely to respect your desire to refuse medical care if an AHCD can be produced stating your directives for health care and designating a representative to act on your behalf. To be well prepared you need a written statement of your wishes. It is also important that your AHCD is state-specific, is executed and applies to the state you are living in: each state has variations in law that your AHCD should cover in order to have maximum validity when presented to the local authorities or medical facilities.

I made a Durable Power of Attorney years ago. Do I need an AHCD?
If you have a document named “Durable Power of Attorney for Health Care,” it is probably out of date. California laws have changed recently and while legally a valid Durable Power of Attorney for Health Care should be honored, it is probably old enough that a doctor might refuse to acknowledge it. It is best to update your estate documents every five years so that you can be current if state laws change and so that doctors relying on your AHCD (or Durable Power of Attorney for Health Care or your living will) know that it reflects your current wishes.

What if I change my mind?
You can always change or revoke an AHCD as long as you are competent, which is to say that you fully understand what you are doing. This means that you can change your choice of agent, your guidelines for making health care decisions, and anything else included in the AHCD.

How do I make sure that my wishes are followed?
No one can guarantee that your wishes will be followed exactly. However, the best chance of having your wishes carried out is to set them out in writing in an AHCD and to talk openly about your desires with your family members and your close friends. Choosing an agent who will respect your wishes whether or not he or she agrees with them is also vital. Once you have an AHCD, you should keep the original with your other estate documents such as your Will, Trust, and Powers of Attorney. You also should give copies to those you have chosen as your agents, as well as family members. It would also be helpful to provide your local Christian Science nursing facility with a copy to have on file. In any event, bring a copy with you if you are being admitted to a nursing facility, hospital, or other health care facility.

Where do I get an AHCD?
You can easily obtain AHCD information and forms developed specifically for Christian Scientists from a Christian Science nursing home near you or contact your Committee on Publication.

Any attorney who practices estate planning, probate or trust administration should also be able to draft an AHCD for you. Attorneys who are familiar with Christian Science are usually better able to draft guidelines that accurately reflect your wishes. Many medical associations (such as the American Medical Association) offer AHCD forms. Large stationery stores often carry Wolcott’s AHCD forms. Forms designed for public use are a low-cost option, but they may need to be changed to reflect your desires for Christian Science care.