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Outline

In Utah, the Advance Health Care Directive serves as a critical tool for individuals planning for future health care decisions. This legally binding document, structured under the guidelines set forth in Utah Code Section 75-2a-117, is meticulously designed to encapsulate a person's health care preferences in various parts. Part I of the document primarily focuses on the appointment of a health care agent—a trusted individual vested with the authority to make health care decisions on behalf of the declarant in situations where they are unable to communicate or make decisions themselves. This part not only allows for the designation of a primary agent but also the appointment of an alternate agent, ensuring continuity of care decisions should the primary agent be unavailable or unable to serve. Moreover, it delineates the scope and limits of the agent's authority, including decision-making power over accepting or refusing medical treatment, hiring and firing health care providers, and consent to medical research or organ donation under certain conditions.

Part II transitions into the living will component, offering a space for individuals to articulate their health care desires directly, thus guiding both the health care agent and medical personnel regarding end-of-life care and other critical medical decisions. This part is particularly significant for it captures the individuals' wishes concerning life-sustaining treatments, such as mechanical ventilation or artificial nutrition and hydration, among other interventions. Here, declarants have the flexibility to detail the extent to which they want medical interventions to prolong their life or, conversely, the conditions under which they would prefer to forego such treatments in favor of palliative care.

Understanding the dynamic nature of personal preferences and medical advancements, the directive also includes provisions in Part III for revoking or amending the document. It outlines several methods through which individuals can render the directive void or update it to reflect their evolved wishes, emphasizing the importance of ensuring that the document remains an accurate reflection of one's health care preferences.

Lastly, Part IV underscores the formal requirements necessary to give legal effect to the directive. By stipulating the need for the declarant's signature, witnessed by individuals who meet specified criteria, this part vests the document with the legal authenticity required to ensure that the specified health care preferences are respected and followed. Through its comprehensive and thoughtful structure, the Utah Advance Health Care Directive empowers individuals to have a decisive voice in their health care journey, even in circumstances where they might not be able to express their wishes verbally.

Preview - Utah Advance Health Care Form

UTAH ADVANCE HEALTH CARE DIRECTIVE

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

Part I: Allows you to name another 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 the form.

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 below. No one can force you to name an agent.

_______

I do not want to choose an agent.

(Initial)

B.My Agent

Agent's Name:

Street Address:

City, State, Zip Code:

Home phone:

 

Cell Phone:

 

Work phone:

C.Alternate Agent.

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

Alternate Agent's Name:

Street Address:

City, State, Zip Code:

Home phone:

 

Cell Phone:

 

Work phone:

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 and 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.

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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

 

incapacitated.

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.

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.

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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

_______

(Initial)

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 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

(Initial)

agent to withhold or withdraw life-sustaining care.

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

_______

(b) My health care provider should withhold or withdraw

(Initial)

life-sustaining care if at least one of the following initialed

 

conditions is met:

_____

I have a progressive illness that will cause death.

(Initial)

 

_____

I am close to death and am unlikely to recover.

(Initial)

 

_____

I cannot communicate and it is unlikely that my

(Initial)

condition will improve.

_____

I do not recognize my friends or family and it is

(Initial) unlikely that my condition will improve.

_____

I am in a persistent vegetative state.

(Initial)

 

Other: _____________________________________________________________________

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Option 4

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

(Initial) directive.

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:

1.Writing "void" across the form, or burning, tearing, or otherwise destroying or defacing this document or directing another person to do the same on my behalf;

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

3.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 appointed 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

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

PART IV: MAKING MY DIRECTIVE 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, naming a health care agent, that I have completed in the past.

___________________

________________________________________________

Date

Print name: ________________________

___________________________________________________________________________

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:

1.Related to the declarant by blood or marriage;

2.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;

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3.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;

4.Entitled to benefit financially upon the death of the declarant;

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

6.Directly financially responsible for the declarant's medical care;

7.A health care provider who is providing care to the declarant or an administrator at a health care facility in which the declarant is receiving care; or

8.The appointed agent or alternate agent.

_______________________________

_______________________________________

Signature of Witness

Printed Name of Witness

 

_________________________________

______________

_________

_________

Street Address

City

State

Zip Code

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

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File Specifications

Fact Detail
Governing Law Utah Code Section 75-2a-117
Part I Purpose Names another person to make health care decisions when you're unable to do so yourself.
Part II Purpose Lets you record your health care wishes in writing.
Revocation Methods Writing "void", physical destruction, written revocation, stating revocation in front of a witness, or by signing a new directive.
Agent's Authority The agent can make health care decisions, hire/fire health care providers, access medical records, and consent to admission/transfer to health care facilities.
Nomination of Guardian You can nominate your agent or alternate agent as your guardian should a guardianship become necessary.
Consent to Medical Research and Organ Donation You can authorize your agent to consent to your participation in medical research or clinical trials and to organ donation.
Legal Requirements for Directive Your signature makes the directive legal, revoking any previous similar documents. Witnesses to the signing cannot be related or entitled to any part of your estate.

How to Write Utah Advance Health Care

Completing the Utah Advance Health Care Directive form is a responsible step in planning for future health care decisions. It allows individuals to specify their wishes regarding medical treatment and appoint someone to make decisions on their behalf if they are unable to do so. Understanding and filling out this form carefully ensures that one's health care preferences are respected and followed.

  1. Start by providing your personal information, including your full name, street address, city, state, zip code, telephone number, cell phone number, and birth date.
  2. In Part I, decide if you want to appoint a health care agent.
    • If you do not wish to appoint an agent, initial the provided box and proceed to Part II.
    • If you choose to appoint an agent, complete the following with their information: full name, address, home phone, cell phone, and work phone numbers.
  3. Select an alternate agent who can serve if your primary agent is unable or unwilling, filling out their information as specified.
  4. Determine the scope of your agent's authority in Part I, Section D, and specify any limitations or expansions of their powers.
  5. If applicable, initial the box in Section G to nominate your agent or alternate agent as your guardian should it become necessary.
  6. In Section H, indicate your consent for your agent to make decisions about participation in medical research or clinical trials.
  7. In Section I, express your wishes regarding organ donation by initialing the appropriate box.
  8. Proceed to Part II and express your health care wishes. Select only one of the options between 1 and 4 and initial your choice. Provide additional comments or instructions as necessary.
  9. Review Part III for information on how to revoke or amend the directive in the future.
  10. In Part IV, sign and date the document to make it legally binding. This act revokes any previous directives.
  11. Ensure that the witness who observes your signature meets the criteria listed, then have them sign and date the document as well.

After completing these steps, it's important to keep the Utah Advance Health Care Directive in a safe but accessible place. Share your decisions with your health care agent, if you have appointed one, family members, and your healthcare providers to ensure your wishes are known and can be acted upon when necessary.

Frequently Asked Questions

  1. What is the purpose of the Utah Advance Health Care Directive?

    The Utah Advance Health Care Directive serves multiple crucial purposes. Firstly, Part I allows you to appoint someone else, referred to as your agent, to make health care decisions on your behalf in the event you are unable to make these decisions or communicate your wishes yourself. This can provide peace of mind, knowing that someone you trust will oversee your health care preferences. Secondly, Part II gives you the opportunity to document your preferences regarding health care directly. This aspect acts as your living will, guiding your appointed agent and health care providers about your wishes concerning life-prolonging treatments, comfort care, or other medical interventions you desire or wish to avoid. Part III outlines the methods you can employ to revoke this directive if you change your mind in the future, ensuring your current wishes are always represented. Finally, Part IV details the steps required to make your directive legally binding, including your signature and the witnessing process. This comprehensive document is designed to ensure your health care wishes are followed, providing both you and your loved ones with certainty and control over your future health care.

  2. How can I choose not to appoint an agent in my Utah Advance Health Care Directive?

    In the Utah Advance Health Care Directive, if you decide not to name an agent to make health care decisions for you, you have the option to indicate this preference clearly. In Part I section A, you simply initial the box next to the statement "I do not want to choose an agent." By doing so, you are choosing to bypass the appointment of a health care agent and can proceed directly to Part II where you can record your own wishes about your health care. This option ensures that no one can be forced into naming an agent, maintaining your autonomy over your health care decisions.

  3. Can I specify limitations on my health care agent's authority in the Utah Advance Health Care Directive?

    Yes, you can specify limitations on your health care agent’s authority within your Utah Advance Health Care Directive. Part I section F allows you to delineate any constraints or expand the powers you grant to your health care agent. This section offers you the flexibility to tailor the agent's decision-making power to align with your preferences and values. You might choose to limit certain types of treatments, specify scenarios where you would like to avoid life-prolonging measures, or clarify any other health care preferences. Documenting these limitations helps ensure that your health care agent acts within the bounds of your wishes.

  4. How can I legally revoke or change my Utah Advance Health Care Directive?

    The Utah Advance Health Care Directive offers several methods for revocation or amendment to ensure that it accurately reflects your current wishes. You may revoke or change your directive by writing "void" across the form, physically destroying the document, signing a written revocation, or verbally expressing your wish to revoke in the presence of a witness who confirms your statement in writing. Additionally, creating a new directive automatically revokes any previous directives, as only the most recent directive is considered legally valid. These options provide the flexibility to adapt your directive as your health care priorities and preferences evolve over time.

Common mistakes

Filling out the Utah Advance Health Care Directive is a crucial step in managing your future health care decisions. However, it's easy to make mistakes on this form, which can potentially lead to misunderstandings or unintended outcomes regarding your health care. Here are ten common errors:

  1. Not specifying an agent because you believe it's unnecessary or assuming family members will automatically make decisions for you. It’s important to designate a health care agent in Part I to ensure someone you trust can make decisions on your behalf if you're unable to.
  2. Choosing an agent or alternate agent without ensuring their availability and willingness to serve. Always discuss your wishes with the people you intend to name as your agent and alternate agent, making sure they are both prepared and willing to take on this responsibility.
  3. Failing to provide clear contact information for the agent or alternate agent, which could lead to delays or complications if they need to be reached in an emergency.
  4. Skipping Part II where you record your health care wishes. This section is your opportunity to make your preferences known, especially regarding end-of-life care and other critical treatments.
  5. Initialing more than one option in Part II, which can create confusion about your true wishes. Be sure to choose only one of the options that best reflects your preferences for health care.
  6. Not being specific about the limits or expansions of your agent’s authority. Without clear directions in Part I, paragraph F, your agent might not know your exact preferences about specific treatments or decisions.
  7. Omitting to initial the consent to participate in medical research and organ donation in Sections H and I, if these are your wishes. This oversight might prevent your participation in research you support or the donation of your organs.
  8. Not properly revoking or changing the directive when your wishes change. Part III outlines the specific steps to revoke or change the directive, and it’s important to follow these instructions to ensure your current wishes are legally recognized.
  9. Forgetting to sign and date the directive in Part IV, making it legally ineffective. Your signature, along with the date and witness verification, is essential to validate the directive.
  10. Choosing an agent or witness who is not eligible under the form’s restrictions. The witness to your directive cannot be related to you by blood or marriage nor stand to inherit anything from your estate, to avoid any potential conflicts of interest.

Beyond these individual errors, a general mistake people often make is not discussing their advance directive with their family, friends, and especially their chosen agent(s). Open communication ensures that everyone understands your wishes and is prepared to respect them should the need arise. Equally important is reviewing and updating your directive periodically or after any significant changes in your health or personal relationships to ensure it always reflects your current wishes.

Avoiding these mistakes can make a significant difference in ensuring your healthcare wishes are known, respected, and legally protected. If any part of the Utah Advance Health Care Directive confuses you, consider seeking assistance from a healthcare professional or a legal expert specializing in advance care planning. This proactive approach will help safeguard your health care decisions and provide peace of mind for you and your loved ones.

Documents used along the form

When considering your health care and end-of-life wishes, it's crucial to have a comprehensive set of documents that clearly outline your preferences. The Utah Advance Health Care Directive is a fundamental tool in this planning process. It allows you to appoint an agent to make health care decisions on your behalf and specify your health care preferences in detail. However, to ensure a fully rounded approach to your health care planning, several other forms and documents often accompany the Utah Advance Health Care Directive, each serving its own unique purpose.

  • Power of Attorney (POA) for Finances: This legal document empowers another person to handle your financial affairs. It's crucial when health issues prevent you from managing your finances, ensuring your bills are paid, and your financial obligations are met.
  • Living Will: While part of the Advance Health Care Directive in Utah, in some states, this is a separate document. It records your wishes regarding life-sustaining treatment if you become terminally ill or permanently unconscious.
  • Physician Orders for Life-Sustaining Treatment (POLST): A POLST form complements an Advance Directive by translating your end-of-life wishes into medical orders. It’s particularly useful for those with serious health conditions.
  • Do Not Resuscitate (DNR) Orders: This medical order prevents emergency medical services from performing CPR if your heart stops or if you stop breathing. It’s important for those who want a natural death without life-prolonging interventions.
  • Declaration for Mental Health Treatment: This form allows you to make decisions about your mental health treatment in advance, including preferences for medications, hospitalization, and electroconvulsive therapy (ECT).
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) protects your medical records. A HIPAA release form gives your health care providers permission to discuss your medical information with designated individuals.
  • Organ and Tissue Donation Registration: While mentioned in the Advance Health Care Directive, specifically designating your wishes regarding organ and tissue donation on a separate form or registry ensures your wishes are known and can be followed.

Each of these documents plays a vital role in ensuring comprehensive health care planning. They work collectively to cover different aspects of your health and well-being, offering a robust network of support for your wishes. By integrating these forms with your Utah Advance Health Care Directive, you can achieve a well-rounded and fully customized plan that respects your values and wishes, providing peace of mind for you and your loved ones.

Similar forms

The Durable Power of Attorney for Health Care is a document that closely resembles the Utah Advance Health Care Directive's Part I, where an individual can designate someone to make health care decisions on their behalf. This similarity lies in the function of allowing individuals to appoint an agent or proxy to act in their stead for medical decisions, should they become unable to make those decisions themselves. Both documents serve the purpose of ensuring that an individual's health care choices are honored, even if they are not capable of communicating them.

A Living Will shares similarities with Part II of the Utah Advance Health Care Directive, as both allow an individual to outline their health care preferences beforehand, particularly concerning end-of-life care and treatment. These documents guide health care providers on whether to prolong life through medical interventions or to focus on palliative care, according to the expressed wishes of the patient, ensuring their autonomy in decision-making is respected.

The Do Not Resuscitate (DNR) Order, while not explicitly mentioned, is conceptually related to the options provided in Part II of the Utah Advance Health Care Directive. A DNR order specifically addresses one's wishes regarding CPR (cardiopulmonary resuscitation) or other life-sustaining measures in the event of cardiac or respiratory arrest. Although more specific and clinically focused than a comprehensive advance directive, both DNR orders and the relevant sections of the directive guide medical professionals on the use of life-sustaining treatments based on patient preference.

The HIPAA Release Form shares essential characteristics with the provision in the Utah Advance Health Care Directive that allows the agent to access medical records. HIPAA, the Health Insurance Portability and Accountability Act, protects the privacy of an individual's health information. By including the authorization for an agent to obtain medical records within the directive, it essentially integrates the function of a HIPAA release, ensuring that the designated agent can make fully informed health care decisions.

The Organ Donation Form is another document with shared purposes with a section of the Utah Advance Health Care Directive. This directive permits an individual to express their wishes regarding organ donation upon their death. Similar to standalone organ donation forms, this allows individuals to contribute to saving or improving others' lives through organ and tissue donation, ensuring their intentions are clear and can be acted upon without delay.

The Medical Research Consent Form parallels the section in the Utah Advance Health Care Directive authorizing the agent to consent to the individual's participation in medical research or clinical trials. This consent is crucial for individuals who wish to contribute to medical science, perhaps even when they might not benefit directly from the research. Including this consent within an advance directive ensures that an individual's wishes concerning research participation are respected, even if they can no longer make decisions themselves.

The Guardianship Nomination is another essential aspect of comprehensive planning, akin to a section in the Utah Advance Health Care Directive. Although appointing an agent under the directive is intended to avoid the need for a guardianship, the directive also includes the option to nominate the agent or alternate agent as a guardian. This ensures continuity in care and decision-making, should a court determine that a guardianship is necessary, mirroring the purpose of a separate guardianship nomination document.

Dos and Don'ts

    When filling out the Utah Advance Health Care Directive form, it is important to follow specific guidelines to ensure your health care wishes are clearly understood and legally valid. Here are eight dos and don'ts to consider:

  • Do carefully consider who you choose as your agent. This person will make decisions on your behalf if you're unable to do so, so it's crucial they understand your wishes and are willing to advocate for them.
  • Do not leave any sections blank that apply to you. If a section does not apply or you choose not to select an option, clearly mark it as such (e.g., by writing "N/A" or crossing it out) to avoid any potential confusion.
  • Do talk to your health care agent and any alternate agents about your health care wishes. Communication is key to ensuring your preferences are clearly understood and followed.
  • Do not forget to initial your choices in Part II regarding your health care wishes. Your initials indicate your specific choices about prolonging life and other critical decisions.
  • Do consider any limits or expansions of authority you want to place on your health care agent's decision-making power. Be as specific as possible to avoid ambiguity.
  • Do not overlook the section on revoking or changing the directive in Part III. Understanding how you can modify your directive in the future is important for maintaining your autonomy.
  • Do ensure the form is properly witnessed as required in Part IV to make it legally valid. Witnesses must meet specific criteria outlined in the document.
  • Do not rely solely on verbal instructions to your health care agent or family members. Formalizing your wishes in writing and in accordance with legal requirements is essential for ensuring they are honored.

Misconceptions

The Utah Advance Health Care Directive is a critical tool in medical and end-of-life planning, offering individuals control over their health care decisions when they can no longer communicate their wishes. Despite its importance, misconceptions about the form persist, potentially leading to confusion or reluctance in its use. Clarifying these misconceptions is crucial for informed decision-making.

  • Misconception 1: Naming an agent means giving up control over health care decisions immediately. The directive only comes into effect if a physician or APRN determines you lack the capacity to make your own health care decisions. Until then, you retain control over all medical decisions.

  • Misconception 2: The health care agent can make decisions against your will. An agent's authority is to make health care decisions that align with your wishes and best interests as stated in the directive or known to the agent. Agents cannot force health care decisions that contradict your known desires.

  • Misconception 3: The directive is only about refusing treatment. While it enables you to refuse or request the withdrawal of life-sustaining treatment, it also allows for specifying desires for treatment, including those intended to prolong life, and outlines conditions under which you would want certain treatments.

  • Misconception 4: Once you complete the form, it cannot be changed. You may revoke or alter your directive at any time by voiding the document, creating a new one, or through a written revocation witnessed by someone 18 years or older who meets specific criteria.

  • Misconception 5: An advance directive is not legally binding. Part IV of the form explicitly makes the directive legal, providing it is signed voluntarily and when you are mentally competent, thereby revoking any previous directives or similar documents.

  • Misconception 6: The directive covers organ donation and medical research fully. While you can express your wishes regarding organ donation and participation in medical research, specific consent forms and additional discussions with your health care provider may be needed to ensure your wishes are fulfilled.

Understanding these nuances is vital for anyone considering filling out an Utah Advance Health Care Directive. It ensures that your health care preferences are respected and followed, offering peace of mind to you and your loved ones.

Key takeaways

When completing the Utah Advance Health Care Directive, there are several key points to keep in mind to ensure your health care wishes are clearly documented and followed:

  1. Naming an Agent: Part I of the form allows you to designate another person as your agent to make health care decisions on your behalf if you become unable to make decisions or speak for yourself.
  2. Alternative to Naming an Agent: If you prefer not to name an agent, you must initial the appropriate section indicating this choice, which directs you to skip to Part II that covers your personal health care wishes.
  3. Defining Agent's Authority: The form details the powers your agent will have, including making health care decisions, hiring or firing health care providers, and accessing your medical records, subject to any limits you specify.
  4. Specifying Conditions for Your Care: You can specify particular types of health care you do or do not want, including life-prolonging measures, under Part II of the directive.
  5. Revoking the Directive: Part III outlines the methods by which you can revoke or change your directive, ensuring flexibility if your wishes or circumstances change over time.
  6. Legal Requirements to Make the Directive Valid: Part IV explains the process to make your directive legally binding, including your signature, date, identification, and witness requirements.
  7. Clarifying Your Health Care Wishes: The directive provides various options for specifying your health care wishes, including whether you want to prolong your life at all costs or prefer not to receive life-prolonging care under certain conditions.
  8. Guardianship Nomination: You can nominate your agent or alternate agent to serve as your guardian in the event that a guardianship becomes necessary, providing a seamless transition of decision-making authority.
  9. Organ Donation and Medical Research Participation: The form allows you to authorize your agent to consent to organ donation and participation in medical research or clinical trials on your behalf.

It is crucial to discuss your health care preferences and the contents of this directive with the person you name as your agent to ensure they understand and are willing to carry out your wishes. Additionally, reviewing and updating the directive periodically or when your health status or preferences change is advisable to ensure it reflects your current wishes.

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