Hastings Science and Technology Law Journal


Peter C. Harman


Since the late 1970s, most states have enacted laws that allow people to set out their health care preferences in advance directives. Advance directive statutes give people the opportunity to make important health care choices in advance, while they still have the mental acuity to make well-informed decisions. These statutes also allow the declarant to change his or her mind in the future, either by revoking the advance directive or by modifying his or her previously expressed preferences.

However, there is one class of people who still have full mental faculties, but have lost the opportunity to change their minds about their advance directives. People who have locked-in syndrome are catastrophically paralyzed; they often can only communicate by blinking. While each state treats the revocation and modification of advance directives differently, some states make it more difficult than others for locked-in patients to legally change their minds. This Note analyzes how state laws currently dictate whether a locked-in patient may revoke or modify a medical advance directive. It argues that the revocation statutes in some states violate the Americans with Disabilities Act of 1990 and must be changed.