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In Utah, residents have the ability to direct their future health care through the creation of an Advance Healthcare Directive, as authorized by Utah Code Section 75-2a-117, effective since 2008. This comprehensive four-part form is designed to ensure an individual's healthcare preferences are known and respected, especially in situations where they might not be able to communicate their wishes themselves. The first section grants individuals the power to name a trusted person to act as their health care agent, making important decisions on their behalf if they are incapacitated. For those who prefer not to appoint an agent, the document offers an option to detail specific health care wishes in writing. Additionally, it outlines the steps necessary to alter or revoke the directive and formally complete the document, making it legally binding. The inclusion of personal information, the selection of an agent, and the ability to specify limits to the agent's authority, including decisions about medical research participation, organ donation, and health care facility admission, allows for a highly personalized directive. Utah's Advance Healthcare Directive form serves as a vital tool for anyone wishing to have control over their future health care, ensuring their medical treatment aligns with their values and preferences, even when they can no longer express those wishes themselves.

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Utah Advance Healthcare Directive

 

(Pursuant to Utah Code Section 75-2a-117, effective 2008)

 

This form contains no modifications from the statutory form.

 

 

Part I:

Allows you to name another the person to make health care decisions for you when you cannot

 

make decisions or speak for yourself.

Part II:

Allows you to record your wishes about health care in writing.

Part III:

Tells you how to revoke or change this directive.

Part IV:

Makes your directive legal.

 

 

My Personal Information

Name: ______________________________________________________________________________

Street Address: _______________________________________________________________________

City, State, Zip Code: _________________________________________________________________

Telephone: (_______) _____________________ Cell Phone: (_______) _____________________

Birth Date: ____________________________

Part I: My Agent (Health Care Power of Attorney)

A: No Agent

If you do not want to name an agent, initial the box below, then go to Part II; do not name an agent in B or C be- low. No one can force you to name an agent.

I do not want to choose an agent.

B: My Agent

Agent’s Name: _______________________________________________________________________

Street Address: _______________________________________________________________________

City, State, Zip Code: _________________________________________________________________

Telephone: (_______) _____________________ Cell Phone: (_______) _____________________

Birth Date: ____________________________

C: My Alternate Agent

This person will serve as your agent if your agent, named above, is unable or unwilling to serve.

Agent’s Name: _______________________________________________________________________

Street Address: _______________________________________________________________________

City, State, Zip Code: _________________________________________________________________

Telephone: (_______) _____________________ Cell Phone: (_______) _____________________

Birth Date: ____________________________

Page 1 of 4

Part I: My Agent (continued)

D: Agent’s Authority

If I cannot make decisions or speak for myself (in other words, after my physician or APRN finds that I lack health care decision making capacity under Section 75-2a-104 of the Advance Health Care Directive Act), my agent has the power to make any health care decision I could have made such as, but not limited to:

•Consent to, refuse, or withdraw any health care. This may include care to prolong my life such as food and fluids by tube, use of antibiotics, CPR (cardiopulmonary resuscitation), and dialysis, and mental health care, such as convulsive therapy and psychoactive medications. This authority is subject to any limits in paragraph F of Part I or in Part II of this directive.

•Hire and fire health care providers.

•Ask questions and get answers from health care providers.

•Consent to admission or transfer to a health care provider or health care facility, including a mental health facility, subject to any limits in paragraphs E or F of Part I.

•Get copies of my medical records.

•Ask for consultations or second opinions.

My agent cannot force health care against my will, even if a physician has found that I lack health care decision making capacity.

E: Other Authority

My agent has the powers below ONLY IF I initial the “YES” option that precedes the statement. I authorize my agent to:

____YES

____ NO

Get copies of my medical records at any time, even when I can speak for myself.

____YES

____ NO

Admit me to a licensed health care facility, such as a hospital, nursing home, assisted living,

 

 

or other facility for long-term placement other than convalescent or recuperative care.

F: Limits/Expansion of Authority

I wish to limit or expand the powers of my health care agent as follows:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

G: Nomination of Guardian

Even though appointing an agent should help you avoid a guardianship, a guardianship may still be necessary. Initial the "YES" option if you want the court to appoint your agent or, if your agent is unable or unwilling to serve, your alternate agent, to serve as your guardian, if a guardianship is ever necessary.

____YES ____ NO I, being of sound mind and not acting under duress, fraud, or other undue influence, do hereby

nominate my agent, or if my agent is unable or unwilling to serve, I hereby nominate my alternate agent, to serve as my guardian in the event that, after the date of this instrument, I become incapaci- tated.

H: Consent to Participate in Medical Research

____YES ____ NO I authorize my agent to consent to my participation in medical research or clinical trials, even if I

may not benefit from the results.

I: Organ Donation

____YES ____ NO If I have not otherwise agreed to organ donation, my agent may consent to the donation of my

organs for the purpose of organ transplantation.

Name: ______________________________________________ (print or type)

Page 2 of 4

Part II: My Health Care Wishes (Living Will)

I want my health care providers to follow the instructions I give them when I am being treated, even if my instructions conflict with these or other advance directives. My health care providers should always provide health care to keep me as comfortable and functional as possible.

Choose only one of the following options, numbered Option 1 through Option 4, by placing your initials before the numbered statement. Do not initial more than one option. If you do not wish to document end-of-life wishes, initial Option 4. You may choose to draw a line through the options that you are not choosing.

Option 1

______________

Initial

I choose to let my agent decide. I have chosen my agent carefully. I have talked with my agent about my health care wishes. I trust my agent to make the health care decisions for me that I would make under the circumstances.

Additional Comments:

Option 2

 

I choose to prolong life. Regardless of my condition or prognosis, I want my health care team

______________

to try to prolong my life as long as possible within the limits of generally accepted health care

 

Initial

standards.

Other:

 

 

 

 

 

 

Option 3

 

 

__________

Initial

I choose not to receive care for the purpose of prolonging life, including food and fluids by tube, antibiotics, CPR, or dialysis being used to prolong my life. I always want comfort care and routine medical care that will keep me as comfortable and functional as possible, even if that care may prolong my life.

If you choose this option, you must also choose either (a) or (b), below

 

_________

(a) I put no limit on the ability of my health care provider or agent to withhold or withdraw life-

 

sustaining care. If you selected (a), above, do not choose any options under (b).

 

Initial

 

 

 

 

_________

(b) My health care provider should withhold or withdraw life-sustaining care if at least one of

 

the initialed conditions is met:

 

Initial

 

 

 

 

Option

 

I have a progressive illness that will cause death

 

3(b)

 

 

 

 

I am close to death and am unlikely to recover

 

only

 

 

 

 

 

You may

 

I cannot communicate and it is unlikely that my condition will improve

 

 

 

 

initial

 

I do not recognize my friends or family and it is unlikely that my condition will improve

 

more than

 

 

 

 

 

 

I am in a persistent vegetative state

 

one option

 

Other:

 

Option 4

______________

I do not wish to express preferences about health care wishes in this directive.

Initial

 

Other:

 

 

 

Name: ______________________________________________ (print or type)

Page 3 of 4

Part II: My Health Care Wishes (continued)

Additional instructions about your health care wishes:

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

If you do not want emergency medical service providers to provide CPR or other life sustaining measures, you must work with a physician or APRN to complete an order that reflects your wishes on a form approved by the Utah Department of Health.

Part III: Revoking or Changing a Directive

I may revoke or change this directive by:

•Writing “void” across the form, burning, tearing, or otherwise destroying or defacing this document or directing an- other person to do the same on my behalf;

•Signing a written revocation of the directive, or directing another person to sign a revocation on my behalf;

•Stating that I wish to revoke the directive in the presence of a witness who: is 18 years of age or older; will not be ap- pointed as my agent in a substitute directive; will not become a default surrogate if the directive is revoked; and signs and dates a written document confirming my statement; or

•Signing a new directive. (If you sign more than one Advance Health Care Directive, the most recent one applies.)

Part IV: Making the Document Legal

I sign this directive voluntarily. I understand the choices I have made and declare that I am emotionally and mentally competent to make this directive. My signature on this form revokes any living will or power of attorney form nam- ing a health care agent that I have completed in the past.

___________________________ ___________________________________________________________

DateSignature

___________________________________________________________

City, County, and State of Residence

I have witnessed the signing of this directive, I am 18 years of age or older, and I am not:

•Related to the declarant by blood or marriage;

•Entitled to any portion of the declarant's estate according to the laws of intestate succession of any state or jurisdiction or under any will or codicil of the declarant,

•A beneficiary of a life insurance policy, trust, qualified plan, pay on death account, or transfer or death deed that is held, owned, made, or established by, or on behalf of, the declarant;

•Entitled to benefit financially upon the death of the declarant;

•Entitled to a right to, or interest in, real or personal property upon the death of the declarant;

•Directly financially responsible for the declarant's medical care;

•A health care provider who is providing care to the declarant or an administrator at a health care facility in which the de- clarant is receiving care; or

•The appointed agent or alternate agent.

_______________________________________________

__________________________________________________

Signature of Witness

Printed Name of Witness

 

 

_______________________________________________

______________________

_________

______________

Street Address

City

State

Zip

If the witness is signing to confirm an oral directive, describe below the circumstances under which the directive was made.

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Name: ______________________________________________ (print or type)

Page 4 of 4
⇓ Utah Healthcare Directive PDF

Form Breakdown

Fact Description
Governing Law Utah Code Section 75-2a-117, effective 2008
Agent Appointment Allows for the naming of another person to make health care decisions when one cannot make decisions or speak for themselves.
Health Care Wishes Enables recording of wishes about health care in writing to guide future care.
Revocation or Changes Outlines how to revoke or change the directive, including verbal, written, and physical destruction methods.
Legal Making Details the process to make the directive legal, including signing the document in the presence of a witness not related or entitled to the declarant's estate.

Detailed Steps for Writing Utah Healthcare Directive

Completing the Utah Healthcare Directive form is a crucial process that requires attention to detail. This guide will help simplify the steps, ensuring that your healthcare wishes are documented accurately and legally. Remember, this document empowers someone you trust to make healthcare decisions on your behalf if you're unable to do so yourself. Additionally, it records your healthcare preferences clearly. Let's walk through the steps needed to fill out the form correctly.

  1. Begin with My Personal Information. Fill in your complete name, street address, city, state, zip code, telephone number, cell phone number, and birth date.
  2. Move to Part I: My Agent (Health Care Power of Attorney).
    • If you choose not to appoint an agent, initial the box in section A and proceed to Part II.
    • If you decide to appoint an agent, complete section B with your agent’s name, address, and contact details. For an alternate agent, fill in section C similarly.
  3. In section D, you don't need to fill anything. However, carefully review the listed powers your agent will have to ensure you agree with them.
  4. For sections E and F, if you wish to grant additional powers to your agent or set specific limits, initial the “YES” option and write down any stipulations or conditions.
  5. If you want your agent or alternate agent to be considered for guardianship, should it become necessary, initial the "YES" option in section G.
  6. In sections H and I, determine whether you wish to allow your agent the authority to consent to medical research participation or organ donation on your behalf. Initial accordingly.
  7. Proceed to Part II: My Health Care Wishes (Living Will). Carefully read through the options regarding your end-of-life care wishes and initial the option that best reflects your preferences. If you have additional instructions, write them down in the space provided.
  8. In Part III: Revoking or Changing a Directive, understand that the document can be changed or revoked by you under the conditions listed. No action is needed here unless you're making changes or revoking an existing directive.
  9. To complete the process, move to Part IV: Making the Document Legal. Sign and date the form, declaring your mental competence to make these decisions. This declaration also revokes any previous directives.
  10. Lastly, have a witness who meets the criteria listed sign and date the form. This is to affirm that you signed the directive voluntarily.

By following these steps, you will have successfully completed the Utah Healthcare Directive form. This document is now legally binding and ensures that your health care decisions will be respected, even if you're not able to communicate them yourself. Keep a copy of this completed form in a safe place and consider providing copies to your appointed agent, alternate agent, and your primary healthcare provider.

Common Questions

  1. What is a Utah Advance Healthcare Directive?

    An Advance Healthcare Directive in Utah is a legal document allowing individuals to outline their healthcare preferences and appoint a trusted person (agent) to make healthcare decisions on their behalf if they are unable to do so themselves. This process is aligned with Utah Code Section 75-2a-117 and became effective in 2008. The directive encompasses decisions around consenting to, refusing, or withdrawing from any form of health care, including life-prolonging treatments.

  2. Do I need to appoint an agent in my Utah Healthcare Directive?

    No, appointing an agent is not mandatory. If you prefer not to designate someone, you can simply initial the appropriate section to indicate your refusal to choose an agent and proceed to detail your healthcare wishes in the directive.

  3. What authority does my healthcare agent have?

    Once your physician or an Advanced Practice Registered Nurse (APRN) verifies that you cannot make decisions for yourself, your agent can make any health care decision you could make. This includes consenting to or refusing medical treatments and accessing your medical records. However, the agent cannot go against your will even after you've been determined to lack decision-making capability.

  4. Can I limit my agent’s powers?

    Yes, you can specify limitations or expand the powers given to your healthcare agent. This customization is possible through detailed written instructions in the designated section of your Advance Healthcare Directive form.

  5. What if a guardianship becomes necessary?

    In the event that you become incapacitated, you have the option to nominate your agent or alternate agent as your guardian. This nomination, however, is only considered if a court decides that a guardianship is necessary.

  6. Can I specify my wishes regarding life-prolonging treatments?

    Yes, the Utah Advance Healthcare Directive allows you to specify whether you wish to receive or decline life-prolonging medical treatments. You can choose from various options that align best with your personal values and wishes regarding end-of-life care.

  7. How can I revoke or change my Advance Healthcare Directive?

    You can revoke or alter your directive at any time. The ways to do so include writing "void" across the document, destroying it, signing a written revocation, verbally revoking it in the presence of a witness, or creating a new directive. The most recent directive is considered valid.

  8. What makes my Utah Advance Healthcare Directive legally binding?

    To make your directive legally binding, you must sign the document, indicating your voluntary decision and understanding of your choices, in the presence of a witness who meets specific criteria to ensure impartiality. The witness must also sign the document, affirming their qualifications.

Common mistakes

Many people who fill out the Utah Healthcare Directive form make common mistakes that could potentially affect their future healthcare decisions. Understanding these mistakes is crucial to ensuring that your healthcare wishes are accurately and effectively communicated.

  1. Not naming an agent or alternate agent. Some individuals skip Part I, which compromises their opportunity to designate a trusted person to make healthcare decisions on their behalf when they are unable to do so themselves. This omission can lead to confusion and delays in decision-making during critical times.
  2. Leaving contact information incomplete. Failing to provide complete and accurate contact information for yourself, your agent, or your alternate agent can significantly hinder communication efforts, especially in emergency situations.
  3. Failing to discuss wishes with the named agent. Merely naming an agent isn’t enough. Not having a thorough conversation with the agent about your healthcare wishes can lead to decisions that may not align with your preferences.
  4. Inconsistencies in decisions. Some individuals select conflicting healthcare options in Part II or provide unclear additional instructions, leading to uncertainty about their true healthcare wishes.
  5. Not specifying limits on the agent’s authority. Without clearly defined limits in Section F of Part I, the agent's decision-making power may be too broad, potentially leading to choices the declarant might not agree with.
  6. Overlooking Part III on how to revoke or change the directive. Individuals often do not plan for future changes in their healthcare wishes or relationships with their agents, leaving outdated directives in place.
  7. Improper or incomplete execution of the document. Not following Part IV's instructions for making the directive legal can result in an invalid document. This may include failing to sign the document, not having the correct witnesses, or missing witness information.
  8. Choosing multiple health care wishes or not making a clear choice. In Part II, selecting more than one option or not initialing any option can create ambiguity regarding end-of-life care preferences.
  9. Ignoring the option to consent to participate in medical research and organ donation. Many individuals overlook Sections H and I, missing the opportunity to make their wishes known regarding organ donation and participation in medical research.

To avoid these common mistakes, it’s important to take time to carefully fill out each part of the Utah Healthcare Directive form, consult with trusted individuals when naming an agent, clearly communicate healthcare preferences, and ensure that the form is properly executed. Careful attention to these details can make all the difference in having one's healthcare wishes honored.

Documents used along the form

When preparing for medical and end-of-life decisions, it's essential to have a comprehensive plan in place. The Utah Advance Healthcare Directive is a crucial document in this process, allowing individuals to outline their healthcare preferences and appoint agents to act on their behalf. However, this form is just one part of a broader spectrum of legal documents that can be used to ensure a person's wishes are honored. Below is a list of other forms and documents often used alongside the Utah Healthcare Directive form, each serving a unique but complementary role.

  • Living Will: Supplements the Healthcare Directive by providing more detailed instructions on end-of-life care preferences, ensuring that medical decisions align with the individual's values and desires.
  • Durable Power of Attorney: Authorizes another person to make financial decisions on behalf of the individual, which is essential for managing assets and liabilities, especially during times of incapacity.
  • Do Not Resuscitate (DNR) Order: A medical order that tells healthcare providers not to perform CPR if the individual's breathing stops or if the heart stops beating. It's a critical component for those who wish to avoid certain life-prolonging procedures.
  • Physician Orders for Life-Sustaining Treatment (POLST): Translates a patient’s end-of-life treatment preferences into medical orders, ensuring that healthcare providers are aware of and comply with the individual's wishes.
  • Will: Specifies how a person's assets and estate will be distributed upon their death, including the appointment of an executor to manage the estate's affairs.
  • Trust Documents: Establish trusts to manage assets during the individual's life and after death, offering a way to control how the estate is distributed to beneficiaries and potentially avoiding the probate process.
  • Guardianship Designation: Allows an individual to nominate a guardian for their minor children or dependents, ensuring they are cared for by a trusted person if the parent or guardian can no longer do so.
  • Organ and Tissue Donation Registration: Indicates the individual's wishes regarding organ and tissue donation, which can be a separate form or included in the Healthcare Directive.
  • HIPAA Release Form: Authorizes healthcare providers to disclose medical information to designated individuals, ensuring that agents and loved ones can access the necessary information to make informed decisions.
  • Funeral Planning Declaration: Allows individuals to outline their preferences for funeral arrangements and the handling of their remains, reducing uncertainty for family members during a difficult time.

Each of these documents serves a specific purpose and works in conjunction with the Utah Healthcare Directive to create a comprehensive plan that respects the individual's wishes and provides guidance to loved ones and medical professionals. When taken together, they offer a clear and actionable roadmap for managing a variety of situations that may arise during incapacity or after death. It's beneficial for individuals to consult with legal and healthcare professionals to ensure these documents are correctly completed and reflect their precise intentions.

Similar forms

The Utah Advance Healthcare Directive form is structurally and functionally analogous to the Living Will document found in several other states. Both documents enable individuals to outline their healthcare preferences in case they become unable to make decisions for themselves. The Living Will typically covers scenarios like life support withdrawal and end-of-life care preferences, similar to the sections in the Utah form where one can specify desires regarding life-prolonging treatments.

Comparably, a Durable Power of Attorney for Health Care (Healthcare Proxy) permits individuals to designate a trusted person to make healthcare decisions on their behalf, much like the Utah form's provision for appointing a healthcare agent. This parallel allows for a seamless transition in decision-making authority when the individual can no longer communicate their healthcare choices directly.

Do-Not-Resuscitate (DNR) orders share commonalities with the Utah directive, particularly in their purpose to communicate critical end-of-life care preferences. While a DNR specifically instructs healthcare providers not to perform CPR, the Utah directive encompasses a broader scope, including preferences on CPR, thereby encasing the DNR's intent within a wider array of healthcare decisions.

Organ Donation Registration forms also find resemblance with the Utah Advance Healthcare Directive, especially in sections concerning organ donation. Both documents allow individuals to express their wishes about donating organs and tissues after death, ensuring these preferences are known and can be followed through with minimal legal obstacles.

The POLST (Physician Orders for Life-Sustaining Treatment) form or its equivalents (e.g., MOLST, MOST) is another document with similarities to the Utah directive, specifically designed to ensure that an individual's end-of-life wishes are respected. Like the Utah directive, POLST forms provide detailed instructions for healthcare providers, including whether to administer treatments that extend life.

Medical Orders for Scope of Treatment (MOST) forms, akin to POLST, offer a direct comparison, particularly in their function to guide emergency medical personnel and healthcare providers about a patient's preferences concerning CPR, intubation, and other life-prolonging interventions. The Utah Advance Healthcare Directive encompasses similar directives, integrating them into one comprehensive document.

The Five Wishes document, though broader in scope and less legally binding in some jurisdictions, shares the spirit of the Utah Healthcare Directive by addressing personal, spiritual, and medical wishes at the end of life. It similarly allows individuals to dictate care preferences, choose a healthcare agent, and express desires regarding comfort care and treatment limitations.

Advance Directive Registrations, which are systems that store and provide access to documents like the Utah Advance Healthcare Directive, facilitate the availability of one's end-of-life care wishes to healthcare providers. The process of registering such directives ensures that the documents' instructions are followed, akin to how the Utah form's directives are intended to guide healthcare decisions when the individual cannot communicate.

Last Will and Testament documents, while primarily used for distributing one's estate posthumously, occasionally intersect with directives like Utah's in the broader context of expressing wishes after death. Though mainly focused on asset distribution, a Last Will can sometimes include personal statements that resonate with the spirit of individual preferences and autonomy, akin to what is seen in healthcare directives.

The HIPAA Release Form, crucial for ensuring that healthcare providers can share an individual’s medical information with designated persons, complements the Utah Advance Healthcare Directive. By naming an agent to make decisions, it implicitly involves sharing protected health information, which aligns with the HIPAA form's objective to facilitate communication between healthcare personnel and a patient's chosen representative or family.

Dos and Don'ts

When filling out the Utah Healthcare Directive form, it's crucial to approach this task with diligence and attention to detail. This document is a legal way to make your health care preferences known if you are unable to speak for yourself. Here are some key dos and don'ts to consider during the process.

Things You Should Do:

  1. Choose an agent or proxy wisely. Select someone who understands your values and whom you trust to make health care decisions on your behalf. Ensure this person is willing and able to take on this responsibility.
  2. Communicate openly with your agent. Discuss your health care wishes with the person you have chosen to act as your agent. Clear communication can prevent confusion and ensure your desires are honored.
  3. Be specific about your health care wishes. Provide detailed instructions in Part II of the form to guide your agent and health care providers. Include preferences regarding life-sustaining treatments, pain management, and any other relevant instructions.
  4. Legally execute the directive. Follow Utah's legal requirements for signing and witnessing the document to ensure it is legally binding. Your signature and the correct completion of the form will validate your advance directive.
  5. Keep the directive accessible. Inform your agent, family members, and health care providers where the document is stored. Consider giving copies to involved parties to ensure your health care wishes are known.

Things You Shouldn't Do:

  1. Delay choosing an agent. Procrastination can lead to a situation where you are unable to make your wishes known. Select an agent as soon as possible to ensure your preferences are respected.
  2. Fail to review and update the form periodically. Your health care wishes may change over time. Review and update your directive as needed to reflect your current preferences.
  3. Omit discussing your choices with your health care providers. It's essential that your doctors are aware of and understand your health care directive. This ensures they can honor your wishes in accordance with your instructions.
  4. Ignore the specifics of state law. Each state has its own laws regarding health care directives. Neglecting the legal requirements in Utah might render your directive invalid.
  5. Use vague language in expressing your wishes. Ambiguous statements can lead to interpretations that might not align with your actual desires. Be clear and precise in outlining your health care preferences.

By following these guidelines, you can ensure that your Utah Healthcare Directive form accurately reflects your wishes and can be effectively implemented by your chosen agent and health care providers.

Misconceptions

There are many misconceptions about the Utah Healthcare Directive form. It's important to understand what this legal document entails to ensure your healthcare wishes are honored. Below are ten common misconceptions and the truths behind them:

  • It's only for the elderly or terminally ill. Anyone over 18 can and should have a Utah Healthcare Directive form. It's about making your health care preferences known, regardless of your current health status.
  • You need a lawyer to complete it. While legal advice may be helpful, especially in complex situations, Utah's form is designed to be completed without a lawyer. Instructions are straightforward, and resources are available for guidance.
  • It's a lengthy and complicated process. The form is intended to be accessible and relatively simple to fill out. Careful consideration of your wishes is essential, but the process of documenting them doesn't have to be complicated.
  • It's expensive. The Utah Advance Healthcare Directive form can be completed without any cost. There may be fees associated with notarization or legal consultation if you choose that route, but these are not required.
  • Only family members can be chosen as agents. You can choose anyone you trust to be your healthcare agent, not just family members. What's important is selecting someone who understands your values and wishes.
  • Once completed, it cannot be changed. You can revoke or change your directive at any time as long as you are mentally competent. The form even includes instructions on how to do so.
  • Doctors won't honor it. Healthcare providers in Utah are legally obligated to follow an advance directive when it's properly executed and presented. Make sure your healthcare providers and loved ones are aware of your directive and know where it's stored.
  • It allows my agent to make financial decisions for me. The Utah Healthcare Directive form specifically relates to healthcare decisions. Financial decisions require a separate document, such as a Power of Attorney for finances.
  • If I don't appoint an agent, the state will make all my healthcare decisions. If you don't appoint an agent, your closest available relative or a court-appointed guardian may make decisions for you. The directive allows you to also make certain healthcare decisions in advance, guiding healthcare providers.
  • Completing the form means I could receive less aggressive medical treatment. The form allows you to express your wishes for the medical treatment you do or do not want. It ensures that your healthcare treatment aligns with your preferences, whether that means electing for all possible interventions or opting for comfort care only.

Understanding these misconceptions and knowing the truths can help you make informed decisions about your healthcare directive. This document is a key part of planning for your future healthcare and can provide peace of mind for you and your loved ones.

Key takeaways

Filling out the Utah Healthcare Directive form is a significant step in managing your healthcare preferences and ensuring that your wishes are followed, especially in situations where you might not be able to make decisions for yourself. Here are key takeaways to guide you through the process:

  • Understanding the Form: The Utah Advance Healthcare Directive form is a legal tool that lets you articulate your healthcare preferences and designate a person to make decisions on your behalf if you're unable to do so. It's designed according to the Utah Code Section 75-2a-117 and became effective in 2008.
  • Choosing an Agent: Part I of the form allows you to appoint someone you trust as your agent to make healthcare decisions for you if you're incapacitated. This includes choosing an alternate agent if your primary choice is unable or unwilling to serve when the time comes.
  • Authority of Your Agent: Your agent can make a broad range of healthcare decisions on your behalf. This authority includes consenting to or refusing medical treatment, hiring and firing healthcare providers, and accessing your medical records, among others. You have the option to set limits or expand on the powers granted to your agent.
  • Recording Your Healthcare Wishes: Part II enables you to specify your preferences for healthcare treatment, particularly concerning end-of-life care. This “living will” section helps ensure that your healthcare providers follow your wishes even if they conflict with other directives or the advice of your family members.
  • Revoking or Changing the Directive: Part III outlines the methods through which you can revoke or alter your healthcare directive. These methods include writing “void” across the form, physically destroying it, signing a written revocation, verbally revoking in the presence of a witness, or creating a new directive.
  • Legal Requirements: To make your healthcare directive legally binding, you must sign the document. If you've filled out previous forms such as a living will or a different power of attorney for healthcare, signing this directive will revoke those earlier documents.
  • Witness Requirements: Your directive must be signed in the presence of a witness who confirms your signature. This witness must be at least 18 years old and should not be a relative, a beneficiary of your estate, directly financially responsible for your medical care, or involved professionally in your medical care.
  • Emergency Medical Services and CPR: If you wish for emergency medical services to withhold CPR or other life-sustaining measures, you need to communicate your wishes through a separate order, completed with a physician or APRN, in addition to this directive.
  • Organ Donation and Medical Research: The directive also gives you the option to make decisions about organ donation and participation in medical research, ensuring your choices in these areas are respected.

Completing the Utah Healthcare Directive form is an act of foresight, allowing your healthcare preferences to be honored and providing clarity and comfort to your loved ones during challenging times. It's essential to discuss your decisions with your chosen agent, loved ones, and healthcare providers to ensure your wishes are clearly understood and can be effectively implemented.

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