Humboldt County Adult Protective Services v. Superior Court (Magney): The California Court of Appeal Reaffirms The Importance Of California’s Health Care Decisions Law And The Need To Have An Advanced Health Care Directive
The California Court of Appeal’s recent decision in Humboldt County Adult Protective Services v. Superior Court (Magney), 4 Cal. App. 4th 548, First District, Division One, Case No. A145981 (Filed October 24, 2016), reaffirms the importance of California’s Health Care Decisions Law and the need to have an advanced health care directive that expresses your health care wishes and appoints a health care agent to ensure they are carried out.
California’s Health Care Decisions Law (California Probate Code § 4600 et seq.) recognizes and protects the fundamental right of adults to control decisions concerning their own health care, including the decision to have life-sustaining treatment withheld or withdrawn. (Cal. Prob. Code § 4650(a).) The Health Care Decisions Law provides the statutory framework for advance health care directives. An “advance health care directive” or “advance directive” is specifically defined to mean “either an individual health care instruction or a power of attorney for health care.” (Cal. Prob. Code § 4605.).
The requirements for creating an advance health care directive are set forth in California Probate Code § 4680 et seq. Unless otherwise specified in the directive, a power of attorney for health care becomes operative only when the principal lacks capacity, and ceases if and when the principal recovers capacity. (Cal. Prob. Code § 4682.) The agent designated under the power of attorney is to make health care decisions for the principal in accordance with “the principal’s individual health care instructions, if any, and other wishes to the extent known to the agent.” (Cal. Prob. Code § 4684.) “Otherwise, the agent shall make the decision in accordance with the agent’s determination of the principal’s best interest,” which includes considering the principal’s “personal values to the extent known to the agent.” (Cal. Prob. Code § 4684.)
In Humboldt, Humboldt County Adult Protective Services (the “County”) filed a petition under the Health Care Decisions Law, ex parte and without notice, to revoke Dick Magney’s written advance directive by removing his wife as his designated agent for health care decisions and to compel medical treatment. The County took this action two weeks after Mr. Magney was hospitalized and while he was receiving palliative care, the course recommended by his treating physician (as well as by his prior treating physician and consulting cardiologist). This was also the course of treatment desired by Mr. Magney and his wife. The County succeeded in procuring a temporary treatment order. It did so on the basis of what the Court of Appeal later described as “an appallingly inadequate evidentiary showing” and by misleading the trial court both as to pertinent provisions of the Health Care Decisions Law and as to Mr. Magney’s medical status. Among other things, the County did not inform the trial court of the treating physician’s opinion that palliative care was appropriate and consistent with Mr. Magney’s wishes. Within days of Mrs. Magney retaining counsel, the County withdrew its petition and the trial court vacated the temporary treatment order. The trial court denied, however, Mrs. Magney’s request for statutory attorney fees.
The Court of Appeal reversed and remanded the matter to the trial court to determine and award Mrs. Magney’s attorney fees.
Under California Probate Code § 4771, a court may award attorney fees to the agent under a power of attorney for health care, if the court determines that a proceeding initiated against the agent was commenced without reasonable cause. The Court of Appeal held that reasonable cause is determined under an objective, reasonable person standard. The Court of Appeal further held that a proceeding against an agent must be supported by competent evidence.
The Court of Appeal held that the County had no reasonable cause to proceed under the Health Care Decisions Law and therefore Mrs. Magney was entitled to recover her statutory attorney fees. The Court of Appeal based its decision on the record that the County had deliberately mislead the trial court as to the facts and the law.
While the holding in Humboldt pertained to Mrs. Magney’s ability to recover attorney fees, the Court of Appeal also reaffirmed the importance of California’s Health Care Decisions Law. The Court of Appeal observed that the Health Care Decisions Law “protects the most personal of decisions and an adult’s choice to die on his or her own terms.” According to the Court of Appeal, “[o]ne of the most important features of an advance directive is that it remains operative if and when the patient loses capacity.” 4 Cal. App. 5th at 572 The Court of Appeal admonished the County, stating that the County “clearly lost sight of the fact that the Health Care Decisions Law does not provide a forum to debate the wisdom of a particular individual’s health care choices.”
In a stern warning to the County and other governmental agencies that may be similarly inclined, the Court of Appeal went on to say:
“We cannot subscribe to a scenario where a governmental agency acts to overturn the provisions of a valid advance directive by presenting the court with an incomplete discussion of the relevant law and a misleading compendium of incompetent and inadmissible evidence and, worse, by withholding critical evidence about the clinical assessments and opinions of the primary physician because that evidence does not accord with the agency’s own agenda. No reasonable person, let alone a governmental agency, would have pursued such a course.”
4 Cal App 5th at 572.
Mr. Magney’s wishes were protected and ultimately carried because he had set forth his wishes in an advanced directive and designated his wife as his health care agent to carry them out. The Humboldt case reaffirms California’s Health Care Decisions Law and highlights the importance of having an advanced health care directive that expresses your health care wishes and appoints a health care agent to ensure they are carried out.