Most people have heard of an advance directive or a living will. Fewer know about the POLST. Both documents address end-of-life medical decisions, but they serve different purposes and operate in different settings. For Mesa residents doing serious end-of-life planning, understanding both and having the right documents in place provides the most complete protection for their wishes.
What Arizona’s Advance Directive Does
Arizona’s advance directive combines what other states sometimes separate into a living will and a healthcare power of attorney. Under Arizona Revised Statutes § 36-3201, an advance directive allows an adult to:
- Designate a healthcare agent who makes medical decisions on their behalf when they can’t communicate their own decisions
- Specify their wishes regarding life-sustaining treatment in various scenarios
- Provide instructions about organ donation, mental health treatment, and other healthcare preferences
The advance directive is a planning document. It’s created while a person is competent and healthy, with the intention of guiding future healthcare decisions if they lose decision-making capacity. Any adult over 18 can execute one in Arizona.
The healthcare agent designated in the advance directive has broad authority to make medical decisions consistent with the principal’s stated wishes. This includes decisions about whether to continue, withhold, or withdraw life-sustaining treatment when the principal has a terminal condition, is in a persistent vegetative state, or has an end-stage condition.
What a POLST Does and How It Differs
POLST stands for Physician Orders for Life-Sustaining Treatment. It’s not an estate planning document, and it’s not drafted by an attorney. It’s a medical order signed by a physician and the patient together that translates end-of-life wishes into immediately actionable medical instructions.
Where an advance directive provides guidance to healthcare providers about a patient’s general wishes, a POLST gives specific medical orders about particular interventions. It typically covers:
- Whether to attempt CPR if the heart stops
- The level of medical intervention desired, from comfort-focused care only to full treatment
- Whether artificial nutrition and hydration should be used
The POLST travels with the patient across care settings and is immediately recognizable to emergency responders, hospital staff, and nursing home personnel. When emergency medical technicians arrive at a scene, they look for the POLST because it provides specific orders they can follow immediately, unlike an advance directive which requires interpretation.
Why Mesa Residents Benefit From Having Both
The advance directive and the POLST complement each other rather than duplicate each other.
The advance directive is appropriate for any adult, regardless of health status. It designates a healthcare agent and provides the legal framework for medical decision-making if capacity is lost. It should be in every adult’s estate plan.
The POLST is most relevant for people who have a serious illness, significant frailty, or who are in the later stages of life and want specific medical orders already in place. It’s not typically created during routine estate planning for healthy adults, but becomes highly relevant as health changes.
A Mesa end-of-life planning lawyer helps Mesa residents create the advance directive as part of their overall estate plan and discusses when a conversation with their physician about a POLST makes sense given their health circumstances and goals.
What Happens Without These Documents
Without an advance directive, Arizona’s healthcare decision-making hierarchy under A.R.S. § 36-3231 determines who makes medical decisions for an incapacitated person. That hierarchy may not match who the person would have chosen, and family disagreements about the right course of treatment can create exactly the conflict that proper planning was designed to prevent.
LifePlan Legal AZ helps Mesa and East Valley families create advance directives that clearly express their healthcare values and designate the right person to carry them out. Attorney Jake Carlson approaches end-of-life planning as a deeply personal conversation, not a form-filling exercise. Reach out to a Mesa end-of-life planning lawyer to discuss what these documents mean for your specific situation and how to make sure your wishes will be honored.