(a) An adult or emancipated minor may give an individual instruction. The instruction may be oral or written. The instruction may be limited to take effect only if a specified condition arises.
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Terms Used In Hawaii Revised Statutes 327E-3

  • Advance health-care directive: means an individual instruction or a power of attorney for health care. See Hawaii Revised Statutes 327E-2
  • Agent: means an individual designated in a power of attorney for health care to make a health-care decision for the individual granting the power. See Hawaii Revised Statutes 327E-2
  • Best interest: means that the benefits to the individual resulting from a treatment outweigh the burdens to the individual resulting from that treatment and shall include:

    (1) The effect of the treatment on the physical, emotional, and cognitive functions of the patient;

    (2) The degree of physical pain or discomfort caused to the individual by the treatment or the withholding or withdrawal of the treatment;

    (3) The degree to which the individual's medical condition, the treatment, or the withholding or withdrawal of treatment, results in a severe and continuing impairment;

    (4) The effect of the treatment on the life expectancy of the patient;

    (5) The prognosis of the patient for recovery, with and without the treatment;

    (6) The risks, side effects, and benefits of the treatment or the withholding of treatment; and

    (7) The religious beliefs and basic values of the individual receiving treatment, to the extent that these may assist the surrogate decision-maker in determining benefits and burdens. See Hawaii Revised Statutes 327E-2

  • Capacity: means an individual's ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health-care decision. See Hawaii Revised Statutes 327E-2
  • Codicil: An addition, change, or supplement to a will executed with the same formalities required for the will itself.
  • Emancipated minor: means a person under eighteen years of age who is totally self-supporting. See Hawaii Revised Statutes 327E-2
  • Health care: means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect an individual's physical or mental condition, including:

    (1) Selection and discharge of health-care providers and institutions;

    (2) Approval or disapproval of diagnostic tests, surgical procedures, programs of medication, and orders not to resuscitate; and

    (3) Direction to provide, withhold, or withdraw artificial nutrition and hydration; provided that withholding or withdrawing artificial nutrition or hydration is in accord with generally accepted health care standards applicable to health-care providers or institutions. See Hawaii Revised Statutes 327E-2

  • Health-care decision: means a decision made by an individual or the individual's agent, guardian, or surrogate, regarding the individual's health care. See Hawaii Revised Statutes 327E-2
  • Health-care institution: means an institution, facility, or agency licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business. See Hawaii Revised Statutes 327E-2
  • Health-care provider: means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession. See Hawaii Revised Statutes 327E-2
  • Individual instruction: means an individual's direction concerning a health-care decision for the individual. See Hawaii Revised Statutes 327E-2
  • Physician: means an individual authorized to practice medicine or osteopathy under chapter 453. See Hawaii Revised Statutes 327E-2
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Power of attorney for health care: means the designation of an agent to make health-care decisions for the individual granting the power. See Hawaii Revised Statutes 327E-2
  • State: means a state of the United States, the District of Columbia, the Commonwealth of Puerto Rico, or a territory or insular possession subject to the jurisdiction of the United States. See Hawaii Revised Statutes 327E-2
(b) An adult or emancipated minor may execute a power of attorney for health care, which may authorize the agent to make any health-care decision the principal could have made while having capacity. The power remains in effect notwithstanding the principal’s later incapacity and may include individual instructions. Unless related to the principal by blood, marriage, or adoption, an agent may not be an owner, operator, or employee of the health-care institution at which the principal is receiving care. The power shall be in writing, contain the date of its execution, be signed by the principal, and be witnessed by one of the following methods:

(1) Signed by at least two individuals, each of whom witnessed either the signing of the instrument by the principal or the principal’s acknowledgment of the signature of the instrument; or
(2) Acknowledged before a notary public at any place within this State.
(c) A witness for a power of attorney for health care shall not be:

(1) A health-care provider;
(2) An employee of a health-care provider or facility; or
(3) The agent.
(d) At least one of the individuals used as a witness for a power of attorney for health care shall be someone who is neither:

(1) Related to the principal by blood, marriage, or adoption; nor
(2) Entitled to any portion of the estate of the principal upon the principal’s death under any will or codicil thereto of the principal existing at the time of execution of the power of attorney for health care or by operation of law then existing.
(e) Unless otherwise specified in a power of attorney for health care, the authority of an agent becomes effective only upon a determination that the principal lacks capacity, and ceases to be effective upon a determination that the principal has recovered capacity.
(f) Unless otherwise specified in a written advance health-care directive, a determination that an individual lacks or has recovered capacity, or that another condition exists that affects an individual instruction or the authority of an agent, shall be made by the primary physician.
(g) An agent shall make a health-care decision in accordance with the principal’s individual instructions, if any, and other wishes to the extent known to the agent. Otherwise, the agent shall make the decision in accordance with the agent’s determination of the principal’s best interest. In determining the principal’s best interest, the agent shall consider the principal’s personal values to the extent known to the agent.
(h) A health-care decision made by an agent for a principal shall be effective without judicial approval.
(i) A written advance health-care directive may include the individual’s nomination of a guardian.
(j) An advance health-care directive shall be valid for purposes of this chapter if it complies with this chapter, or if it was executed in compliance with the laws of the state where it was executed.

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