(a) A competent adult or emancipated minor may make a written advance mental health care directive declaring preferences or instructions regarding mental health treatment. The preferences or instructions may include consent to, or refusal of, mental health treatment. An advance mental health care directive may be a part of, or combined with, a written advance health care directive under chapter 327E.

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Terms Used In Hawaii Revised Statutes 327G-3

  • 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
  • Competent adult: means an individual eighteen years of age or older who has the capacity to understand the significant benefits, risks, and alternatives to proposed mental health care or treatment and to make and communicate mental health care decisions. See Hawaii Revised Statutes 327G-2
  • Emancipated minor: means an individual less than eighteen years of age who is deemed to be emancipated pursuant to § 577-25. See Hawaii Revised Statutes 327G-2
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Guardian: means a judicially appointed guardian or conservator having authority to make a mental health care decision for a principal, appointed under part 3 of article V of chapter 560. 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
  • 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: means the designation of an agent to make mental health care decisions for the principal granting the power. 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
  • 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 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) A principal, in a power of attorney contained in the written advance mental health care directive, may designate a competent adult to act as an agent to make any and all mental health care and mental health treatment decisions on behalf of the principal when the principal lacks capacity, unless otherwise specified or limited by the advance mental health care directive. A principal, in a power of attorney contained in the written advance mental health care directive, may also designate competent adults to act as alternate agents, in the order so designated, if the original agent is unable or unwilling to act.
(c) A written advance mental health care directive may include the principal’s nomination of a guardian. The court shall make its appointment of a guardian in accordance with the principal’s most recent nomination in a valid and unrevoked advance mental health care directive, except for good cause shown.
(d) No individual shall be required to execute or refrain from executing an advance mental health care directive or power of attorney as a condition for insurance coverage, receiving mental or physical health services, receiving privileges while in a health care institution, or as a condition of discharge from a health care institution.
(e) An advance mental health care directive is valid and effective only if it is in writing, contains the date of its execution, is signed by the principal, and is witnessed in one of the following methods:

(1) Signed by at least two competent adults, except those as provided in subsection (f), each of whom shall attest that the principal is known to them, signed the advance mental health care directive in their presence, and appears to be of sound mind and not under duress, fraud, or undue influence; or
(2) Acknowledged before a notary public within this State.
(f) None of the following may serve as a witness to the signing of an advance mental health care directive:

(1) A health care provider, supervising health care provider, or an employee or relative of a health care provider or supervising health care provider;
(2) An owner, operator, or employee of a health care provider or health care institution in which the principal is a patient or resident;
(3) A person related to the principal by blood, marriage, or adoption; or
(4) The agent or alternate agents.
(g) None of the following may serve as an agent or alternate agent under a designation in a power of attorney contained in an advance mental health care directive:

(1) A health care provider, supervising health care provider, or an employee of a health care provider or supervising health care provider, unless that person is related to the principal by blood, marriage, or adoption; or
(2) An owner, operator, or employee of a health care provider or health care institution in which the principal is a patient or resident, unless that person is related to the principal by blood, marriage, or adoption.
(h) An advance mental health care directive and power of attorney becomes effective when it is delivered to a health care provider, supervising health care provider, or health care institution and remains effective until revoked.
(i) An advance mental health care directive executed prior to [July 13, 2004,] shall be valid for the purposes of this chapter if it complies substantially with this chapter or if it was executed in compliance with the laws of the state where it was executed.