Know when health care providers must follow your instructions for medical care -- and when they may not.

After you've gone to the trouble of writing down your wishes for medical treatment in a health care directive, you may be concerned about what would happen if a doctor or hospital doesn't want to follow your instructions.

To put your mind at ease, know that health care providers are generally required to comply with the wishes you set out in your health care documents -- and to honor your health care agent's authority as long as the agent's directions are a reasonable interpretation of your wishes.

In some situations, however, a health care provider is permitted to reject a medical decision made by you or your agent. This may be true if:

• the decision goes against the conscience of the individual health care provider
• the decision goes against a policy of a health care institution that is based on reasons of conscience, or
• the decision would lead to medically ineffective health care or health care that violates generally accepted health care standards applied by the health care provider or institution.

But this doesn't mean that your health care instructions can be ignored. A health care provider who refuses to comply with your wishes or the directions of your health care agent must promptly inform you or your agent. And if you or your agent wishes, the provider must immediately take steps to transfer you to another provider or institution that will honor your directive. In some states, a health care provider who intentionally violates these rules may be legally liable for damages.