HB1687 creates the “Uniform Health Care Decisions Act of 2026” and replaces Oklahoma’s existing advance directive and health care agent statutes with a single, updated framework for advance health care planning. The bill defines when an adult or emancipated minor has capacity to make or revoke health care decisions, presumes capacity unless rebutted, and sets out procedures for notice, objection, and expedited court review when capacity is disputed. It authorizes individuals to create health care instructions, powers of attorney for health care, and advance mental health care directives, and it provides a detailed optional form covering treatment preferences, surrogate selection, guardian nomination, and organ donation.
The measure also establishes a hierarchy for default surrogates when no agent is appointed or available, beginning with a person the individual previously identified, then spouse, adult children, parents, cohabitants, siblings, grandparents, and others with supported decision-making experience or special care and concern. It sets duties for agents, default surrogates, health care professionals, and institutions, including documentation requirements, good-faith reliance protections, transfer obligations when providers object on conscience or standards-of-care grounds, and court remedies for disputes or interference. The bill expressly addresses electronic directives, out-of-state directives, revocation, coagents and alternate agents, guardianship interactions, and limits on decisions involving life-sustaining treatment, nutrition, hydration, and mental health admissions.
HB1687 would substantially revise Title 63 by repealing the Oklahoma Advance Directive Act and the Oklahoma Health Care Agent Act and replacing them with the new uniform act, while preserving validity for certain existing directives and default surrogate arrangements. It also creates new civil causes of action and statutory damages for falsifying, concealing, coercing, or interfering with advance directives, and for intentional violations by health care professionals or institutions. The act is effective July 1, 2027, and applies to directives created before, on, or after that date.
The overall sentiment in committee and on the floor was strongly favorable. The bill advanced unanimously in the House Civil Judiciary Committee, the House Judiciary and Public Safety Oversight Committee, and the Senate Health & Human Services Committee, and it passed the Senate 47-0. Final House action also showed broad support, passing 74-3. The transcript snippet reflects a lack of additional questions and a request to advance the bill without objection, consistent with a generally noncontroversial, consensus-driven measure.
The main points of contention are not reflected in the recorded votes, but the bill’s detailed rules suggest likely areas of concern: end-of-life decision-making, withdrawal of life-sustaining treatment, mental health directives that can limit revocation during specified episodes, nursing home placement authority, and the balance between patient autonomy and provider conscience or institutional policy. The bill also contains protections against abuse and conflicts of interest by disqualifying certain facility personnel and persons with abuse-related findings from serving as agents or default surrogates, which may have been intended to address concerns about vulnerable adults and coercion.
The bill would overhaul Oklahoma law governing advance health care directives by repealing the existing advance directive and health care agent statutes and replacing them with a new uniform statutory scheme in Title 63. It expands and clarifies who may make health care decisions, how capacity is determined, how surrogates are selected, and how directives are executed, revoked, enforced, and litigated. It also creates new duties and liability rules for health care professionals, institutions, agents, default surrogates, and guardians, while preserving certain existing directives and recognizing valid out-of-state and electronic documents.
The most likely areas of contention involve end-of-life choices, especially withholding or withdrawing life-sustaining treatment, artificial nutrition and hydration, and the scope of authority given to agents and default surrogates. Mental health directives, including provisions that can limit revocation during a specified psychiatric or psychological event, may also raise concerns about autonomy and due process. In addition, the bill’s conscience-based refusal provisions for providers and institutions, along with its restrictions on who may serve as a surrogate or agent in nursing facilities, could be points of disagreement among patient-rights advocates, providers, and elder-care stakeholders.