Decisions About Your Healthcare
How You Can Plan For the Future With Living Wills and Other Healthcare Directives
This information is about your right to make and control your own healthcare decisions. You are encouraged to talk with your family and your doctor about these issues, even if you are not ill.
Who makes your healthcare decisions?
You have the right to make your own healthcare decisions, as long as you are able to make those decisions and communicate them. Your doctors should tell you about the treatment they recommend, reasonable alternatives, and important medical risks and benefits of that treatment and the alternatives. You have the right to decide what healthcare, if any, you will accept.
What happens if you become unable to make or communicate your healthcare decisions?
You can still have some control over your healthcare decisions, if you have planned ahead. One way to plan ahead is by making a healthcare directive that names someone to make these decisions for you if you are unable, or which guides or controls these decisions.
What is a healthcare directive?
It is a written statement about who can make decisions for you and what your wishes are. Under Arizona law, there are four common types of healthcare directives. They are:
- In a healthcare power of attorney, you name an adult to make healthcare decisions for you. That person will make healthcare decisions for you only when you cannot make or communicate those decisions yourself.
- In a mental healthcare power of attorney, you name an adult to make decisions for you about your mental healthcare. That person will make mental healthcare decisions for you only when you cannot make or communicate those decisions yourself.
- In a living will, you tell others about healthcare you want or do not want if you are unable to make your own healthcare decisions. For example, a living will can say whether you would want to be fed through a tube if you were in a coma and unlikely to recover.
- In a prehospital medical care directive, you refuse cardiopulmonary resuscitation (CPR), a type of lifesaving emergency care, if you have a heart attack or can’t breathe. To make one, you must complete a special orange form. This directive is generally done by people with terminal illnesses who do not want to be saved if they have a heart attack or other emergency outside a hospital or in a hospital emergency room.
Must your healthcare directives be followed?
Yes. Both healthcare providers and surrogates must follow valid healthcare directives. However, a prehospital medical care directive applies only in the hospital emergency room or when emergency medical personnel respond to a call for emergency help.
Can you be required to make a healthcare directive?
No. Whether you make a healthcare directive is entirely up to you. A healthcare provider cannot refuse care based on whether or not you have a healthcare directive.
Can you change or revoke healthcare directives?
Yes. If you change or revoke a healthcare directive, you should notify everyone who has a copy.
Can you revise your healthcare directives?
Yes. You have the right to revise your healthcare directives at any time. You should review your healthcare directives once in a while and update them if your wishes change.
Who can legally make healthcare decisions for you if you are unable to make your own decisions?
If a court appoints a guardian to make your healthcare decisions, your healthcare providers will look to the guardian. If you don’t have a guardian, but you name someone as an “agent” in your healthcare power of attorney or mental healthcare power of attorney to make your healthcare decisions, your heath care providers will look to your agent to make those decisions.
If you don’t have a guardian or an agent under a power of attorney, your healthcare providers must ask other people that are close to you to make these decisions. A person who makes healthcare decisions for you is called a surrogate. To find a surrogate, your healthcare provider must go down the following list in order of priority to find a surrogate to make healthcare decisions for you:
- Your husband or wife, unless you are legally separated.
- Your adult child. If you have more than one adult child, the healthcare provider will follow the wishes of a majority of your children who are available.
- Your mother or father.
- Your domestic partner, unless someone else has financial responsibility for you.
- Your brother or sister.
- A close friend of yours (someone who shows special concern for you and is familiar with your healthcare views.)
If your healthcare provider cannot find a person in this list that is available and willing to make healthcare decisions for you, then your doctor can make decisions for you if your doctor asks for the advice of an ethics committee or another doctor.
You can stop anyone from becoming your surrogate by saying that you do not want that person to make healthcare decisions for you. It is best to do this in writing.
What types of decisions may your surrogate make about your healthcare?
A surrogate (in the list above) may make any decision about your healthcare, as long as that decision is consistent with the wishes you have expressed in your healthcare directives. A surrogate cannot refuse the use of tubes to give you food or fluids unless you have stated in your healthcare directive that you do not want this treatment.
Can a surrogate make decisions about your mental healthcare?
Yes. A guardian appointed by a court, a person you name in your healthcare power of attorney or mental healthcare power of attorney, or a surrogate (in the list above), can makes decisions about your mental healthcare treatment. However, these people cannot admit you to an inpatient psychiatric hospital for longer than 48 hours unless you give them that authority in your healthcare power of attorney or your mental healthcare power of attorney, or if a court gives the person this authority.
What if you made a healthcare directive in another state?
If you made a healthcare directive in another state, it is valid in Arizona as long as it was valid in the other state.
Do you need a lawyer to make a healthcare directive?
No. Just be sure that your directive is valid under Arizona law.
When is a power of attorney valid?
Unless your power of attorney was made before September 1992, a healthcare power of attorney or mental healthcare power of attorney must:
- Name a person to make healthcare decisions for you if you become unable to make your own decisions. You may also name an additional person or persons to make decisions for you if your first choice cannot serve. The person or persons must be at least 18 years old.
- Be signed or marked by you and dated.
- Be signed by a notary or by an adult witness, who saw you sign or mark the document and who says that you appear to be of sound mind and free from duress. A notary or witness cannot be the person you name to make your decisions and cannot be providing healthcare to you. If you have only one witness, that witness cannot be related to you or someone who will get any of your property if you die.
- If you give this person power to admit you to an inpatient psychiatric hospital, this paragraph must be separately initialed by you.
When is a living will valid?
Unless your living will was made before September 1992, the living will must:
- State how you want your healthcare decisions to be made in the future.
- Be signed or marked by you and dated.
- Be notarized or witnessed in the same way as described above for a healthcare power or attorney.
When is a prehospital medical care directive valid?
A prehospital medical care directive must:
- Be in exactly the form required by law.
- Be printed on an orange background.
- Be signed or marked by you and dated.
- Be signed by a licensed healthcare provider and a witness.
If you have signed an orange prehospital medical care directive, you may also wear a special orange bracelet. It must state your name, your doctor’s name, and the words “do not resuscitate.” This bracelet will call to the attention of emergency medical personnel that you have completed the form and that you do not want cardiopulmonary resuscitation outside a hospital or in a hospital emergency room.
You should talk to your doctor about prehospital medical care directive if you are thinking about signing one. Forms are available through the Office of Emergency Medical Services in the Department of Health Services, although any prehospital medical care directive which is in the exact form that meets the requirements of the law may be used.
Who should have copies of your healthcare directives?
It is very important that you give copies to your doctors now. You should give copies to any healthcare facility upon admission. You should give copies to anyone who you have named to make healthcare decisions for you in a healthcare power of attorney or mental healthcare power of attorney. Be sure to keep extra copies for yourself.
What if you have problems with your healthcare directives?
You can always speak to your healthcare providers. Also, you can file a complaint with the Arizona Department of Health Services if you believe your healthcare providers are not following the law.
Where can you get forms and more information?
You can ask your healthcare provider to give you forms. Also, you can get forms and information from:
Aging and Adult Administration State of Arizona
1789 West Jefferson, Site Code 950A, Phoenix, AZ 85007
Dorothy Garske Center
4250 East Camelback, Suite 185K, Phoenix, AZ 85018
Arizona Senior Citizens Law Project
1818 South 16th Street, Phoenix, AZ 85034
Arizona State Registry Program
Your local Area Agency on Aging and Senior Center may also have forms and information.