As a healthcare agency licensed by the Arizona Department of Health and Human Services we are bound to follow Arizona law in making healthcare decisions. If a patient is able to make his/her own decisions, the patient should be asked and those decisions must be honored. The challenging area is when a patient is unable to express their wishes, most often due to a debilitating condition like Alzheimer’s disease or Dementia.
Ideally, the patient has put in place advance directives to specify his or her wishes. Advance directives should be made when the patient still has legal capacity — the level of judgment and decision-making ability needed to sign official documents or to make medical and financial decisions. Without such directives, or if certain issues have not been addressed, decisions should be made based on what they believe the person would want. End-of-life decisions should respect the person’s values and wishes while maintaining comfort and dignity.
According to Arizona law, the order of people authorized to make health care decisions is:
- Health Care (Medical) Power of Attorney
- The patient’s spouse, unless legally separated
- An adult child of the patient, or a majority of adult children
- A parent of the patient
- The patient’s domestic partner if the patient is unmarried
- A brother or sister of the patient
- A close friend of the patient
- If none of the above can be located, the attending physician, after consulting with an ethics committee. If unavailable, the physician may make these decisions after consulting a second physician.
Important Exception: Only the patient, a guardian, or a medical power of attorney can make the decision to withdraw the artificial administration of food or fluid.
All other medical treatment decisions (including the withdrawal of ventilator, dialysis and other life support measures) can be made by the appropriate decision-maker listed above.
For more information, view A.R.S. Section 36-03231.