Healthcare advance directives
The patient's right to decide
Every competent adult has the right to make decisions concerning his or her own health, including the right to choose or refuse medical treatment. When a person becomes unable to make decisions due to a physical or mental change, such as being in a coma or developing dementia (such as Alzheimer’s disease), they are considered incapacitated.
To make sure that an incapacitated person’s decisions about healthcare will still be respected, the state of Arizona enacted legislation pertaining to healthcare advance directives. The law recognizes the right of a competent adult to make an advance directive instructing his or her physician to provide, withhold, or withdraw life-prolonging procedures; to designate another individual to make treatment decisions if the person becomes unable to make his or her own decisions; and/or to indicate the desire to make an anatomical donation after death.
Questions about healthcare advance directives
What is an advance directive?
It is an oral or written statement about how an individual wants medical decisions to be made should they not be able to make the decisions themselves and/or it can express the wish to make an anatomical donation after death. Some people create advance directives when they are diagnosed with a life-threatening illness. Others put their wishes into writing while they are healthy, often as part of their estate planning. Three types of advance directives are:
- A living will
- A healthcare surrogate designation
- An anatomical donation
A person may wish to complete any one or a combination of the three types of advance directives, depending on their needs.
What is a living will?
It is an oral or written statement about the kind of medical care a person wants or does not want if they become unable to make their own decisions. It is called a living will because it takes effect while they are still living. Many individuals discuss this with their healthcare provider or attorney to be certain they have completed the living will in a way that their wishes will be understood.
What is a healthcare surrogate designation?
It is a document in which a person names someone else to make medical decisions for them if they are unable to do so. It can include instructions about any treatment a person does or does not want, similar to a living will. It may also designate an alternate surrogate.
What is an anatomical donation?
It is a document that indicates a person’s wish to donate, at death, all or part of their body. This can be an organ and tissue donation to persons in need, or the donation of their body for the training of healthcare workers. A person can indicate their choice to be an organ donor by designating it on their driver’s license or state identification card, signing a uniform donor form, or expressing their wish in a living will.
Are individuals required to have an advance directive under state law?
No, there is no legal requirement to complete an advance directive. However, without one, decisions about a person’s healthcare or an anatomical donation may be made by a court-appointed guardian, a spouse, an adult child, a parent, an adult sibling, an adult relative, or a close friend. The person making decisions may or may not be aware of a person’s wishes. An advance directive better assures that a person’s wishes will be carried out.
Must an attorney prepare the advance directive?
No, the procedures are simple and do not require an attorney, although some people choose to consult one. However, an advance directive, whether it is a written document or an oral statement, needs to be witnessed by two people. At least one of the witnesses cannot be a spouse or a blood relative.
Can a person change their mind after completing an advance directive?
Yes, an advance directive can be changed at any time. Any changes should be written, signed and dated. However, it can also be changed with an oral statement, physical destruction of the advance directive, or by writing a new advance directive. If a person’s driver’s license or state identification card indicates they are an organ donor but they no longer want this designation, they can contact the nearest driver’s license office to cancel the donor designation and a new license or card will be issued.
What if an individual filled out an advance directive in another state and needs treatment in Arizona?
An advance directive completed in another state, as described in that state’s law, can be honored in Arizona.
What should a person do with their advance directive if they choose to have one?
If a person wants to designate a healthcare surrogate and an alternate surrogate, they must be sure to ask them if they agree to take on this responsibility, discuss with them how matters should be handled and provide them with a copy of the document.
Make sure that their healthcare provider, attorney and the significant persons in their life know that they have an advance directive and tell them where it is located or provide them with a copy.
Set up a file where a copy of the advance directive (and other important paperwork) can be kept. Some people keep original papers in a bank safety deposit box.
Keep a card or note in their purse or wallet that states they have an advance directive and where it is located.
If an individual changes their advance directive, they should be sure that their healthcare provider, attorney and other significant persons in their life have the latest copy.
More information on healthcare advance directives
Before making a decision about advance directives, a person might want to consider additional options and other sources of information, including the following:
- Designating a durable power of attorney, through a written document naming another person to act on their behalf. It is similar to a healthcare surrogate, but the person can be designated to perform a variety of activities (e.g., financial, legal, medical, etc.). An attorney can provide further information.
Here is a list of additional sources of information about advance directives:
Arizona Secretary of State - Advance Directives
Aging with Dignity - The Five Wish’s Arizona
Arizona Attorney General