Most people think of estate planning as deciding who gets what after they die. But some of the most important documents in your plan do their work while you’re still alive. If an accident or illness ever leaves you unable to speak for yourself, someone will have to make your medical decisions. Arizona lets you choose that person and put your wishes in writing. Without the right health care directives, who acts for you falls to a default list written by the legislature, and when families disagree, to a judge. All without your voice and wishes considered. Here’s how Arizona health care directives work, and why every adult needs them.
What is a health care directive?
A health care directive is a document that speaks for you about medical care when you can’t speak for yourself. Arizona recognizes several types, and a complete plan usually includes more than one:
Health Care Power of Attorney. Names a trusted adult (your “agent”) to make medical decisions for you if you can’t make or communicate them yourself, under A.R.S. § 36-3221. You can name backup agents, and the same document can also cover your funeral and burial or cremation arrangements.
Living Will. Written instructions about end-of-life treatment, such as CPR, breathing machines, and feeding tubes, under A.R.S. § 36-3261. It can stand on its own or be attached to your health care power of attorney to guide your agent.
Mental Health Care Power of Attorney. Names an agent to make mental health treatment decisions if a qualified physician or psychologist finds you unable to give informed consent, under A.R.S. § 36-3281.
Prehospital Medical Care Directive (DNR). A form printed on orange paper that tells paramedics and emergency room staff not to perform CPR if your heart or breathing stops, under A.R.S. § 36-3251. It’s usually a choice for people facing serious illness or advanced age.
HIPAA Authorization. Not technically a health care directive, but an important companion document. It allows your doctors to share your medical information with the people you choose.
What happens if you don’t have one?
If you can’t make your own decisions, haven’t named an agent, and no court has appointed a guardian, Arizona’s surrogate statute, A.R.S. § 36-3231, tells your doctors whom to turn to, in this order:
Your spouse, unless you are legally separated
Your adult children (if you have more than one, a majority of those reasonably available)
Your parents
Your domestic partner, if you are unmarried
Your brothers and sisters
A close friend who knows your health care views
If no one on the list can be found, your doctor may make decisions after consulting an ethics committee or a second physician.
That default list works well enough for many everyday decisions. But it is a backup, not a plan:
It may not match your choice. The order is set by statute, not by your relationships. A spouse you’ve separated from informally, but not legally, still ranks first. An unmarried partner of twenty years ranks behind your adult children and your parents.
Some decisions are off-limits. A default surrogate who isn’t your named agent or court-appointed guardian cannot consent to permanently removing a feeding tube (A.R.S. § 36-3203), and cannot admit you to an inpatient psychiatric facility.
Disagreements go to court. Any interested person can petition the superior court to challenge a surrogate’s decision under A.R.S. § 36-3206. And if a guardian’s decision to remove a feeding tube is challenged, Arizona law presumes that a patient without a directive would want food and fluids to continue, unless the evidence clearly shows otherwise.
How do you sign a valid health care directive in Arizona?
Arizona’s signing rules for health care directives are simpler than the rules for a will, but they are still strict. Under A.R.S. § 36-3221, a health care power of attorney must:
Clearly show your intent to create a health care power of attorney.
Be dated and signed by you.
Be notarized or witnessed by at least one adult who affirms that you appeared to be of sound mind and free from duress when you signed.
The law also limits who can serve as your witness or notary. It can’t be your agent, or anyone directly involved in your health care at the time. If you use only one witness, that person also can’t be related to you by blood, marriage, or adoption, and can’t be entitled to any part of your estate, whether under your will or by law. A living will that isn’t attached to a health care power of attorney must be signed the same way.
Mistakes and misunderstandings with health care directives
Thinking you’re too young. Accidents, strokes, and sudden cardiac arrests don’t check your age first. The most tragic of these situations involve those young with a different support or family structure that the backup statute did not consider.
Assuming your family can decide everything. Default surrogates have limits, and the statutory list may put the wrong person in charge.
Choosing an agent who doesn’t know your wishes. Your agent must follow your wishes when they are known. When they aren’t, your agent is left to guess. Their thoughts and morals become yours.
Being vague. “No heroic measures” means different things to different people. Be crystal clear about what you want: CPR, breathing machines, and feeding tubes, and in what situations.
Naming co-agents who don’t get along. Two agents who must agree can deadlock at the worst possible moment. One agent with a clear line of backups is usually cleaner. It feels safe and intuitive to have multiple people, but it usually means a more difficult process.
Hiding the documents. A directive locked in a safe deposit box, or in a drawer no one knows about, can’t help you in an emergency room at 2 a.m.
Expecting a living will to stop the paramedics. Emergency responders aren’t required to follow directives that don’t meet the orange-form requirements. If you don’t want CPR in an emergency, you need a prehospital medical care directive under A.R.S. § 36-3251.
Never updating. Marriage, divorce, a new diagnosis, a move, or a falling-out with your agent are all reasons to revisit your documents.
How to make sure your health care directive actually works
Pick the right agent. Choose someone who stays calm under pressure, can be reached quickly, and will follow your wishes even if they would choose differently. You should trust this person to make the best decisions. Name at least one backup.
Have the conversation. Tell your agent and your family what you want, and why. The document sets the rules. But the conversation can lay out the why.
Be specific. Address the scenarios that matter most, like a terminal condition, an irreversible coma, or a persistent vegetative state, and the treatments you would or wouldn’t want in each.
Sign it correctly. Follow Arizona’s witness and notary rules exactly.
Share copies. Give copies to your agent, your backups, and your doctors, and keep the original where it can be found.
Register it. Arizona’s free Healthcare Directives Registry, established under A.R.S. § 36-3291, stores your documents so participating health care providers can access them when they’re needed.
Review it regularly. Look at your directives every few years, and always after a major life event.
Done correctly, these documents turn a medical crisis into a plan: the person you chose, following instructions you wrote, without a courtroom or family bickering in sight.
Frequently Asked Questions
Who makes my medical decisions in Arizona if I don’t have a health care power of attorney?
Your health care providers turn to Arizona’s default surrogate list under A.R.S. § 36-3231: your spouse (unless legally separated), then your adult children, parents, an unmarried domestic partner, siblings, and finally a close friend. Default surrogates can make many decisions, but not all. For example, they can’t consent to permanently removing a feeding tube. That takes an agent you named or a court-appointed guardian.
Is a living will the same thing as a DNR?
No. A living will explains your wishes about end-of-life treatment and guides your agent and your doctors. A prehospital medical care directive, often called a DNR, is a specific orange form under A.R.S. § 36-3251 that tells paramedics and emergency room staff not to perform CPR. Emergency responders aren’t required to follow other documents in its place.
Does my health care power of attorney let my agent handle my finances?
No. A health care power of attorney covers medical decisions (and, if you choose, funeral and burial or cremation arrangements). Financial decisions require a separate durable financial power of attorney under A.R.S. § 14-5501, which has its own, stricter signing requirements, including both a witness and a notary.
Is a health care directive I signed in another state valid in Arizona?
Generally, yes. Under A.R.S. § 36-3208, a directive prepared in another state is valid in Arizona if it was valid where and when it was signed, to the extent it doesn’t conflict with Arizona’s laws. Still, if you’ve moved here (or split your time here), it’s worth having your documents reviewed so your agent and your Arizona doctors aren’t working from unfamiliar forms.
Do I need a lawyer to make a health care directive?
Not strictly. Arizona law includes sample forms, and any document that meets the statutory requirements is valid. But generic forms are often vague, easy to sign incorrectly, and disconnected from the rest of your estate plan. An attorney can make sure your directives are properly executed, specific enough to follow, and coordinated with your will, trust, and financial power of attorney.
Can I change or revoke my health care directive?
Yes. Under A.R.S. § 36-3202, you can revoke a directive by putting it in writing, by telling your agent or a health care provider, by signing a new directive, or by any other act that clearly shows your intent. (Mental health care powers of attorney follow special rules.) An amendment must be dated, signed, and witnessed or notarized just like the original (A.R.S. § 36-3222). After any change, collect the old copies and update the registry.
Next Steps
Health care directives are some of the simplest documents in an estate plan, and some of the most important. But they only work if they are signed correctly, specific enough to follow, and in the right hands when a crisis hits.
See what happens when no one knows what you would have wanted in The Horrors of Es Tate’s Planning: The Tug-of-War at the Bedside (coming Thursday!).
We’ll help you choose the right agent, put your wishes into clear, enforceable language, and coordinate your health care directives with the rest of your estate plan. Schedule your Free 30-Minute Peace of Mind Session with the Danza Law Office. 100% virtual and deeply personal, from anywhere in Arizona.
This post is for informational purposes only and does not constitute legal advice. Reading it does not create an attorney-client relationship. Laws change, and every situation is different, so please consult an attorney about your specific circumstances.
