4650. The Legislature finds the following:
(a) In recognition of the dignity and privacy a person has a right
to expect, the law recognizes that an adult has the fundamental
right to control the decisions relating to his or her own health
care, including the decision to have life-sustaining treatment
withheld or withdrawn.
(b) Modern medical technology has made possible the artificial
prolongation of human life beyond natural limits. In the interest of
protecting individual autonomy, this prolongation of the process of
dying for a person for whom continued health care does not improve
the prognosis for recovery may violate patient dignity and cause
unnecessary pain and suffering, while providing nothing medically
necessary or beneficial to the person.
(c) In the absence of controversy, a court is normally not the
proper forum in which to make health care decisions, including
decisions regarding life-sustaining treatment.
4651. (a) Except as otherwise provided, this division applies to
health care decisions for adults who lack capacity to make health
care decisions for themselves.
(b) This division does not affect any of the following:
(1) The right of an individual to make health care decisions while
having the capacity to do so.
(2) The law governing health care in an emergency.
(3) The law governing health care for unemancipated minors.
4652. This division does not authorize consent to any of the
following on behalf of a patient:
(a) Commitment to or placement in a mental health treatment
(b) Convulsive treatment (as defined in Section 5325 of the
Welfare and Institutions Code).
(c) Psychosurgery (as defined in Section 5325 of the Welfare and
4653. Nothing in this division shall be construed to condone,
authorize, or approve mercy killing, assisted suicide, or euthanasia.
This division is not intended to permit any affirmative or
deliberate act or omission to end life other than withholding or
withdrawing health care pursuant to an advance health care directive,
by a surrogate, or as otherwise provided, so as to permit the
natural process of dying.
4654. This division does not authorize or require a health care
provider or health care institution to provide health care contrary
to generally accepted health care standards applicable to the health
care provider or health care institution.
4655. (a) This division does not create a presumption concerning
the intention of a patient who has not made or who has revoked an
advance health care directive.
(b) In making health care decisions under this division, a patient'
s attempted suicide shall not be construed to indicate a desire of
the patient that health care be restricted or inhibited.
4656. Death resulting from withholding or withdrawing health care
in accordance with this division does not for any purpose constitute
a suicide or homicide or legally impair or invalidate a policy of
insurance or an annuity providing a death benefit, notwithstanding
any term of the policy or annuity to the contrary.
4657. A patient is presumed to have the capacity to make a health
care decision, to give or revoke an advance health care directive,
and to designate or disqualify a surrogate. This presumption is a
presumption affecting the burden of proof.
4658. Unless otherwise specified in a written advance health care
directive, for the purposes of this division, a determination that a
patient lacks or has recovered capacity, or that another condition
exists that affects an individual health care instruction or the
authority of an agent or surrogate, shall be made by the primary
4659. (a) Except as provided in subdivision (b), none of the
following persons may make health care decisions as an agent under a
power of attorney for health care or a surrogate under this division:
(1) The supervising health care provider or an employee of the
health care institution where the patient is receiving care.
(2) An operator or employee of a community care facility or
residential care facility where the patient is receiving care.
(b) The prohibition in subdivision (a) does not apply to the
(1) An employee, other than the supervising health care provider,
who is related to the patient by blood, marriage, or adoption, or is
a registered domestic partner of the patient.
(2) An employee, other than the supervising health care provider,
who is employed by the same health care institution, community care
facility, or residential care facility for the elderly as the
(c) A conservator under the Lanterman-Petris-Short Act (Part 1
(commencing with Section 5000) of Division 5 of the Welfare and
Institutions Code) may not be designated as an agent or surrogate to
make health care decisions by the conservatee, unless all of the
following are satisfied:
(1) The advance health care directive is otherwise valid.
(2) The conservatee is represented by legal counsel.
(3) The lawyer representing the conservatee signs a certificate
stating in substance:
"I am a lawyer authorized to practice law in the state where this
advance health care directive was executed, and the principal or
patient was my client at the time this advance directive was
executed. I have advised my client concerning his or her rights in
connection with this advance directive and the applicable law and the
consequences of signing or not signing this advance directive, and
my client, after being so advised, has executed this advance
4660. A copy of a written advance health care directive, revocation
of an advance directive, or designation or disqualification of a
surrogate has the same effect as the original.