Advance health care directives; Uniform Health Care Decisions Act of 2025; definitions; capacity; presumption of capacity; overcoming presumption; notice; judicial review; power of attorney; advance mental health care directive; conflicting health care directives; default surrogate; disqualification; revocation; validity; conflict of law; duties; powers; coagents; responsibilities; immunity; conduct; damages; judicial relief; effective date.
HB1687 creates the “Uniform Health Care Decisions Act of 2025” and replaces Oklahoma’s existing advance directive framework with a new, comprehensive set of rules for making and carrying out health care decisions when a person cannot decide for themselves. The bill defines key terms, presumes adults have capacity unless a court or qualified professional finds otherwise, and gives individuals a right to object to a capacity finding. It also establishes procedures for judicial review, documentation, notice, and the use of electronic records and signatures.
The bill authorizes several forms of advance planning, including health care instructions, powers of attorney for health care, advance mental health care directives, co-agents, alternate agents, and default surrogates when no agent is available. It spells out who may serve, who is disqualified, how conflicts are resolved, and what duties agents and surrogates owe in following the patient’s wishes or best interests. It also addresses special issues such as life-sustaining treatment, artificial nutrition and hydration, mental health treatment, nursing home placement, guardianship, and organ donation, while limiting an agent’s authority in certain settings unless specifically authorized by the individual.
The bill would repeal Oklahoma’s current advance directive statutes in Title 63, Sections 3101.1 through 3101.16, and replace them with a new statutory scheme codified beginning at Section 3100 of Title 63. It would govern the creation, revocation, interpretation, and enforcement of advance health care directives for adults and emancipated minors, including directives created before the effective date. It also creates new civil remedies and damages for falsifying directives, coercing decisions, or intentionally violating health care instructions, while providing immunity for good-faith reliance by health care professionals and institutions. The act would take effect November 1, 2025, and would affect patients, agents, default surrogates, guardians, health care providers, nursing homes, and health care institutions statewide.
The bill appears to have broad support in the House, moving through committee unanimously and passing third reading 87-6. That voting pattern suggests general agreement with updating and standardizing Oklahoma’s advance directive law. The bill’s structure and use of the uniform act model also indicate an effort to align Oklahoma with a broader interstate framework for health care decision-making.
The main areas of potential contention are the bill’s treatment of end-of-life decisions, mental health directives, and the scope of authority given to agents and default surrogates. It includes detailed limits on withholding life-sustaining treatment, restrictions on nursing home placement, and special rules for advance mental health directives that can temporarily limit revocation, which may raise concerns for patient autonomy or family involvement. Another possible point of dispute is the balance between honoring patient instructions and allowing health care professionals or institutions to refuse care on conscience, religious, or standards-of-care grounds, as well as the bill’s strong penalties and litigation remedies for interference with directives.