(a) The supervising health care provider, health care provider, or health care institution shall continue to obtain the principal‘s informed consent to all mental health treatment decisions when the principal has capacity to provide informed consent or refusal. Unless the principal is deemed to lack capacity pursuant to this chapter, the instructions or decisions of the principal at the time of mental health treatment shall supersede the preferences or instructions expressed in the principal’s advance mental health care directive.
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Terms Used In Hawaii Revised Statutes 327G-10

  • Advance mental health care directive: means a written document expressing preferences, instructions, or a power of attorney for mental health treatment. See Hawaii Revised Statutes 327G-2
  • Agent: means a competent adult designated in a power of attorney contained in an advance mental health care directive to make a mental health care decision for the individual granting the power and includes all designated alternate agents. See Hawaii Revised Statutes 327G-2
  • Capacity: means a principal's ability to understand the significant benefits, risks, and alternatives to proposed mental health care or treatment and to make and communicate a mental health care decision. See Hawaii Revised Statutes 327G-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 327G-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 327G-2
  • Mental health care: means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a principal's mental condition, including:

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

    (2) Approval or disapproval of diagnostic tests, surgical procedures, and programs of medication; and

    (3) Approval or disapproval of electroconvulsive treatment. See Hawaii Revised Statutes 327G-2

  • Mental health treatment: means any form of treatment used for the treatment of mental illness, including but not limited to electroconvulsive treatment, the use of psychotropic medication, and admission to and retention in a health care facility for the care or treatment of mental illness. See Hawaii Revised Statutes 327G-2
  • Physician: means an individual authorized to practice medicine or osteopathy under chapter 453. See Hawaii Revised Statutes 327G-2
  • Principal: means a competent adult or emancipated minor who has executed a written advance mental health care directive or power of attorney for mental health care. See Hawaii Revised Statutes 327G-2
  • Psychologist: means an individual authorized to practice psychology under chapter 465. See Hawaii Revised Statutes 327G-2
  • Supervising health care provider: means the primary physician or the physician's designee, or the health care provider or the provider's designee who has undertaken primary responsibility for a principal's health care, that includes mental health care. See Hawaii Revised Statutes 327G-2
(b) Upon being presented with an advance mental health care directive, the supervising health care provider or health care institution shall make the advance mental health care directive a part of the principal’s medical record. When acting under the authority of an advance mental health care directive, the supervising health care provider, health care provider, or health care institution shall comply with it to the fullest extent possible, consistent with reasonable medical practice, the availability of treatments requested, and applicable law. In the event that one or more parts of the advance mental health care directive cannot be followed, all other parts of the advance mental health care directive shall nonetheless be followed.
(c) A supervising health care provider, health care provider, or health care institution may consider an advance mental health care directive to be valid and rely upon it in the absence of actual knowledge or notice of its revocation or invalidity.
(d) If the supervising health care provider or health care institution is unwilling at any time to comply with the advance mental health care directive or instructions of an agent, the supervising health care provider or health care institution may withdraw from providing mental health treatment consistent with the exercise of independent medical judgment. Upon withdrawal, the supervising health care provider or health care institution shall promptly notify the principal and agent and shall promptly record the notification in the principal’s medical record.
(e) A physician or licensed psychologist, who in good faith determines that the principal has or lacks capacity in accordance with this chapter to decide whether to invoke an advance mental health care directive, is not subject to criminal prosecution, civil liability, or professional disciplinary action for making and acting upon that determination.
(f) In the absence of actual knowledge or notice of the revocation of an advance mental health care directive, the supervising health care provider, health care provider, or health care institution shall not be subject to criminal prosecution, civil liability, or professional disciplinary action as a result of providing or withholding mental health treatment to a principal in accordance with this chapter or the advance mental health care directive, unless the absence of actual knowledge or notice resulted from the negligence of the supervising health care provider, health care provider, or health care institution.
(g) The supervising health care provider, health care provider, or health care institution who provides or withholds mental health treatment under this chapter or the advance mental health care directive shall not incur liability arising out of a claim to the extent that the claim is based upon lack of informed consent or authorization for the action.
(h) This section shall not be construed as affecting or limiting liability that arises out of a negligent act or omission in connection with the medical diagnosis, care, or mental health treatment of a principal under an advance mental health care directive or that arises out of any deviation from reasonable medical standards.
(i) This chapter does not authorize or require a supervising health care provider, health care provider, or health care institution to provide mental health treatment contrary to generally accepted health care standards applicable to the health care provider or institution.

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