The California Health Care Power of Attorney (2026 Update)

What happens to your medical care if you cannot speak for yourself? A car accident, sudden illness, or medical emergency can leave you unable to communicate your healthcare wishes to doctors and nurses.

Without someone legally authorized to speak on your behalf, your family may face delays, confusion, or court proceedings at the worst possible time.

A California Health Care Power of Attorney gives someone you trust the legal authority to make medical decisions for you. This document, part of what California law calls an Advance Health Care Directive (AHCD), is one of the most important protections you can put in place for yourself and your family.

For California residents in San Diego County and throughout the state, understanding how this document works can prevent significant stress and uncertainty during a medical crisis.

Key Takeaways: California Health Care Power of Attorney

• A California Health Care Power of Attorney names an agent to make medical decisions when you cannot communicate your wishes, under California Probate Code Section 4700.
• California requires two adult witnesses OR notarization for the document to be legally valid, with specific rules about who can serve as a witness.
• Your agent can consent to or refuse treatment, select healthcare providers, access medical records, and make anatomical gift decisions.
• This is different from a living will (which covers only end-of-life situations) and a financial power of attorney (which cannot make healthcare decisions).
• Without this document, your family may need to petition for a conservatorship through probate court to make medical decisions for you.

What Is a California Health Care Power of Attorney?

A California Health Care Power of Attorney is a legal document that designates a trusted person (called your “agent” or “health care agent”) to make medical decisions on your behalf if you become unable to make or communicate those decisions yourself.

Under California Probate Code Section 4700, this document takes effect only when your primary physician determines that you lack the capacity to make your own healthcare decisions.

In California, the Health Care Power of Attorney is typically part of a broader document called an Advance Health Care Directive (AHCD). The state provides a standardized statutory form that combines the power of attorney with written instructions about your treatment preferences. Many estate planning attorneys in Carlsbad and throughout San Diego County create customized versions tailored to each client’s specific wishes and circumstances.

Think of it this way: your Health Care Power of Attorney names the person who will speak for you, while the instructions portion of your Advance Health Care Directive tells that person what you want them to say.

Why Do You Need a Health Care Power of Attorney?

Without a Health Care Power of Attorney, no one automatically has the legal authority to make medical decisions for you. Many people assume their spouse, adult children, or parents can step in, but California law does not grant that authority without proper documentation.

If you become incapacitated without this document in place, your family faces two difficult options. They can ask doctors to make decisions based on what they believe you would want, which works for some routine matters but often creates conflict when family members disagree.

Or they can petition the probate court for a conservatorship, a public and often expensive process that can take weeks or months while you remain in the hospital.

We have seen families in San Diego County go through this process. The emotional toll of petitioning for a conservatorship while a loved one is in the hospital is significant. The Health Care Power of Attorney prevents this situation entirely by establishing clear authority before it is needed.

Health Care Power of Attorney vs. Living Will vs. Financial Power of Attorney

People often confuse these three documents. Each serves a distinct purpose, and you likely need all three as part of a comprehensive estate plan.

The key distinction: A living will only applies in specific end-of-life situations and provides written instructions rather than naming a decision-maker. A Health Care Power of Attorney applies to any situation where you cannot make decisions and gives your agent broad authority to handle whatever medical situation arises.

What Authority Does Your Health Care Agent Have?

Under California Probate Code Section 4683, your health care agent has broad authority to make medical decisions. Specifically, your agent can:

• Consent to or refuse any medical treatment, procedure, or medication
• Select and discharge healthcare providers and facilities
• Access your medical records and private health information
• Make decisions about diagnostic tests and procedures
• Decide whether to use life support systems
• Make decisions about resuscitation if your heart stops or breathing ceases
• Make anatomical gift decisions (organ donation)

You can include specific instructions in your document that guide or limit your agent’s authority. For example, you might specify certain treatments you want to receive or refuse, religious or cultural considerations that should guide decisions, or situations where you would or would not want life-sustaining treatment.

California Legal Requirements for a Valid Health Care Power of Attorney

California Probate Code Sections 4700 and 4701 establish specific requirements that must be met for your Health Care Power of Attorney to be legally valid.

Witness Restrictions

California law restricts who can serve as a witness to your Advance Health Care Directive. The following people cannot be witnesses:

• Your designated health care agent
• Your healthcare provider or an employee of your healthcare provider
• An operator or employee of a community care facility or residential care facility where you live

Special Rule for Skilled Nursing Facility Residents

If you sign your Advance Health Care Directive while a patient in a skilled nursing facility, California law requires that one of your two witnesses must be a patient advocate or ombudsman. This additional protection helps ensure that patients in nursing facilities are making these decisions freely and without undue influence.

When Does Your Health Care Power of Attorney Take Effect?

Your health care agent’s authority begins when your primary physician determines you lack capacity to make your own medical decisions. This is sometimes called a “springing” power because it springs into effect upon incapacity.

Until that determination is made, you retain full authority over your own healthcare decisions. Your agent cannot override your wishes while you are capable of expressing them.

If you regain capacity, your authority to make your own decisions is restored. The power of attorney does not give your agent permanent control; it provides backup decision-making authority only when needed.

How Do You Choose the Right Health Care Agent?

Selecting the right person to serve as your health care agent is one of the most important decisions in this process. In our experience working with California families, we have found that the best health care agents share several characteristics:

• Someone you trust completely to respect and follow your wishes, even when those wishes might be difficult to carry out
• Someone who can remain calm and make difficult decisions under pressure
• Someone who is geographically accessible and able to respond if a medical emergency occurs
• Someone who is willing to advocate for your wishes even if they conflict with what doctors recommend, or what other family members want
• Someone who knows and understands your values, religious beliefs, and preferences regarding medical care

You should also name an alternate agent in case your primary choice is unavailable or unable to serve when the time comes. Life circumstances change, and having a backup ensures your wishes will still be carried out.

Including Living Will Instructions in Your Advance Health Care Directive

California’s Advance Health Care Directive allows you to include written instructions about your healthcare preferences, often called “living will” provisions. These instructions guide your agent and healthcare providers about your wishes in specific situations.

Common topics addressed in living will instructions include:

• Life-sustaining treatment preferences (ventilators, feeding tubes, dialysis)
• Pain management and comfort care preferences
• Resuscitation wishes (CPR, defibrillation)
• Organ and tissue donation preferences
• Religious or cultural considerations that should guide treatment decisions

The more specific your instructions, the easier it will be for your agent to make decisions that reflect your actual wishes.

POLST: An Additional Document for Seriously Ill Patients

California also uses a document called a POLST (Physician Orders for Life-Sustaining Treatment) for patients with serious illnesses or limited life expectancy. Unlike an Advance Health Care Directive, a POLST is a medical order signed by a physician that provides immediately actionable instructions to emergency responders and healthcare providers.

The POLST is a bright pink form that is standardized across California. It supplements, but does not replace, your Advance Health Care Directive. If you or a family member has a serious medical condition, ask your healthcare provider whether a POLST is appropriate.

How to Create Your California Health Care Power of Attorney

Creating this important document involves several key steps:

1. Choose your health care agent and alternate agent carefully. Have conversations with them about your values and wishes before asking them to serve.
2. Think through your healthcare preferences. Consider end-of-life scenarios, your feelings about various treatments, and any religious or cultural values that should guide decisions.
3. Prepare the document. You can use California’s statutory form or work with an estate planning attorney to create a customized document that addresses your specific circumstances.
4. Execute the document properly. Sign and date the document in the presence of two qualified witnesses OR a California notary public.
5. Distribute copies to the right people. Give copies to your health care agent, alternate agent, primary care physician, and any specialists who treat you regularly. Keep the original in a safe but accessible place.
6. Review and update as needed. Your healthcare wishes and circumstances may change over time. Review your Advance Health Care Directive every few years or after major life events.