What are Psychiatric Advance Directives in Oregon?

Oregon’s Declaration for Mental Health Treatment (ORS 127.736) is the Oregon form for a Psychiatric Advance Directive (PAD). It allows people who suffer from a mental illness with severe episodic occurrences to express their wishes for health care treatment and personal affairs during a time when they are able to clearly make those decisions. Oregon is one of the states that permit psychiatric advance directives.

What is involved in a PAD?

With a PAD, you have the ability to give advance directives about your health care and personal needs in the event you suffer from the inability to make decisions yourself due to a period of severe mental health problems. You may do this through advance instructions that specify your desires. You may also do this through the appointment of an agent. Both can also be accomplished in the same directive. You can express your personal wishes but also appoint an agent to act on your behalf.

Do I need an attorney?

An attorney is not required. If you have any questions or concerns, you should speak to an attorney.

What is needed to make a PAD valid?

You must fill out the official declaration. It must have your name clearly marked. It must be signed and dated by you and you need two witnesses present to sign that know you and believe you are mentally competent at the time you sign the form. These witnesses cannot be an attending physician of your or relative of theirs, an owner, operator, or relative of an owner or operator of a health care facility in which you are a patient or resident. The witnesses must also not be related to you by blood, marriage, or adoption. It must contain instructions about your mental health care, or instructions for appointment of an agent, or both. These steps make the PAD valid, but to put it in place to be used in the future, you must tell your doctor or health provider and give them a copy. It is also a good idea to keep another somewhere safe or with someone you trust to keep it safe. If you appoint an agent, they should retain a copy as well.

How long is it a PAD valid?

A PAD is valid for three (3) years unless revoked sooner. If you become incapable of making health care decisions during the three-year period, it stays in effect until you recover the ability to make those decisions.

What are reasons that make a PAD a good choice?

If you suffer from a mental illness that causes you to have periodic episodes of mental incapacitation, a PAD may be worth considering. You can plan for episodes of incapacitation by providing instructions on your future care. You can request certain medication be used, you can deny certain medications, and you can direct what should be done with various personal aspects of your life while unable to care for that. Your pet and houseplant care can be directed ahead of time. You can also use the form to educate the care providers on important health notes regarding your care. If you know that a certain place or song will help you, you can list that. If you want anyone notified of your health status, you can also put that in the PAD. It can make a very difficult part of mental illness a bit easier for you. While it is a useful tool, it should be planned very carefully and may be discussed with your mental health care provider.

Who can be appointed as an agent in a PAD?

It is recommended to choose someone who knows you well so that they can make decisions closely aligned with what you would make if you were able to. This cannot be a health care provider of yours or an owner, operator, or employee of a health care facility where you live or are a patient unless this person is related to you. Other people may be prohibited based on various circumstances. Consult with an attorney if you have any concerns. You may also choose an alternate agent in the instance your agent is unable to serve for you.

How does a PAD become active?

A PAD becomes active when the person who created it is unable to make their own treatment decisions. This can only be decided by a court or two physicians.

Are there times when my PAD can be ignored?

If you are involuntarily committed, you are subject to Oregon’s involuntary treatment laws and the directive is not effective. In emergencies that threaten life or health, a PAD may not be followed. If you are committed to a hospital as a result of being found guilty of a crime other than by insanity, your PAD may not be followed. Also, a provider may decline to follow your PAD if it is not in accordance with their professional judgment.

How can I change my PAD?

As long as you are capable of understanding decisions made for your health care, you may choose to change your PAD at any time by changing your form, writing a new form, or cancelling the old form. Make sure to give the cancellation notice, updated form, or new form to all of the same care providers and any others you anticipate that may treat you.

Legal Disclaimer:

The information on this page does not constitute legal advice and should not be relied upon as each situation is fact specific and it is impossible to evaluate a legal problem without a comprehensive consultation and review of all the facts and documents at issue. The information on this page is solely for the purpose of legal education and is intended to only provide general information about the matters stated therein. The information on this page should not be used as a substitute for competent legal advice from a licensed attorney that practices in the subject area of the matters stated therein. No attorney-client relationship is formed without an actual agreement confirmed in writing. We have attorneys licensed in Washington, Oregon, and Arizona.