Guardianships are generally reserved for people who have not appointed somebody to handle their medical decisions. Those who plan in advance, however, can choose for themselves who will handle their medical decisions, and can significantly reduce the likelihood that they will ever require a guardian’s assistance. Legal tools are available, which, if used properly, can serve as alternatives to Arizona guardianships:
1. Health care power of attorney
A health care power of attorney allows an individual (called a principal) to designate an agent who can make health care decisions in the event that he or she loses capacity to do so. Principals can revoke or change a power of attorney at any time, so long as they have capacity. To be valid, an Arizona health care power of attorney must:
- Clearly delegate the power to make health care decisions to a specific person;
- Be signed by a principal who is of sound mind and free from duress; and
- Be witnessed by at least one adult who is not the agent, relative or heir to the principal, or directly involved in providing health care to the principal.
2. Mental healthcare power of attorney.
Individuals can designate the same person or somebody else to make their mental health care decisions by creating a mental health care power of attorney. An agent must have this type of power of attorney to admit a principal for inpatient mental health treatment without court proceedings. An Arizona mental health care power of attorney can either be entirely separate from the health care power of attorney, or incorporated into the regular health care power of attorney so that one document covers both medical and mental health issues.
Arizona law allows what is referred to as a surrogate to make decisions for a person who does not have powers of attorney or an appointed guardian. While surrogates can obtain ordinary health care for the person under their stewardship, they cannot withdraw life-sustaining treatment, and ordinarily cannot consent to inpatient mental health care. The law gives priority to the following persons in the order given to act as a surrogate:
- The person’s spouse.
- The person’s child.
- The person’s parent.
- The person’s domestic partner, if the person is unmarried and nobody else has accepted financial responsibility.
- One of the person’s siblings.
- A close friend of the person who knows the person’s health care wishes.
- The person’s attending physician, if nobody else can be located.
4. Living wills.
A living will is yet another tool people can use to make their health care decisions known to others. Arizona living wills can be either specific or general. For example some living wills simply proscribe life-sustaining treatment. Other living wills are far more specific, and provide detailed instructions on pain relief, antibiotics, hydration, feeding, and the use of ventilators or cardiopulmonary resuscitation. A thorough living will that outlines important health care decisions in advance can many times preclude the need for a guardianship.