Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 134 (2025GS)

Sponsor

Sen. McKell, Michael K.

Final action

Governor Signed 3/26/2025

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• enacts the Uniform Health Care Decisions Act;
• enacts provisions related to advance health care directives including mental health care directives;
• creates an optional form;
• enacts provisions related to allowing a health care provider to be a surrogate for health care decision making in limited circumstances;
• enacts provisions related to liability and immunity regarding health care decision making;
• repeals provisions related to advance-health care directives not contained in the Uniform Health Care Decisions Act;
• renumbers sections pertaining to orders for life sustaining treatment; and
• makes conforming and technical changes.

Every vote on this bill

Bill text

45
75A-3-101
75A-3-106
75A-3-102
75A-3-103
75A-3-104
75A-3-105
75A-3-107
75A-3-201
75A-3-202
75A-3-203
75A-3-204
75A-3-205
75A-3-206
75A-3-207
75A-3-208
75A-3-301
75A-3-302
75A-3-303
75A-3-304
75A-3-305
75A-3-306
75A-3-307
75A-3-308
75A-3-309
75A-9-101
75A-9-102
75A-9-103
75A-9-104
75A-9-105
75A-9-106
75A-9-107
75A-9-108
75A-9-109
75A-9-110
75A-9-111
75A-9-112
75A-9-113
75A-9-114
75A-9-115
75A-9-116
75A-9-117
75A-9-118
75A-9-119
75A-9-120
75A-9-121
75A-9-122
75A-9-123
75A-9-124
75A-9-125
75A-9-126
75A-9-127
75A-9-128
75A-9-129
Health Care Decisions Act Amendments
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Michael K. McKell
House Sponsor: Jordan D. Teuscher
LONG TITLE
General Description:
This bill enacts the Uniform Health Care Decisions Act.
Highlighted Provisions:
This bill:
defines terms; 
enacts the Uniform Health Care Decisions Act;
enacts provisions related to advance health care directives including mental health care 
directives;
creates an optional form;
enacts provisions related to allowing a health care provider to be a surrogate for health 
care decision making in limited circumstances;
enacts provisions related to liability and immunity regarding health care decision making; 
repeals provisions related to advance-health care directives not contained in the Uniform 
Health Care Decisions Act;
renumbers sections pertaining to orders for life sustaining treatment; and
makes conforming and technical changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
This bill provides a special effective date.
Utah Code Sections Affected:
ENACTS:
75A-9-101
, Utah Code Annotated 1953
75A-9-102
, Utah Code Annotated 1953
75A-9-103
, Utah Code Annotated 1953
75A-9-104
, Utah Code Annotated 1953
75A-9-105
, Utah Code Annotated 1953
75A-9-106
, Utah Code Annotated 1953
75A-9-107
, Utah Code Annotated 1953
75A-9-108
, Utah Code Annotated 1953
75A-9-109
, Utah Code Annotated 1953
75A-9-110
, Utah Code Annotated 1953
75A-9-111
, Utah Code Annotated 1953
75A-9-112
, Utah Code Annotated 1953
75A-9-113
, Utah Code Annotated 1953
75A-9-114
, Utah Code Annotated 1953
75A-9-115
, Utah Code Annotated 1953
75A-9-116
, Utah Code Annotated 1953
75A-9-117
, Utah Code Annotated 1953
75A-9-118
, Utah Code Annotated 1953
75A-9-119
, Utah Code Annotated 1953
75A-9-120
, Utah Code Annotated 1953
75A-9-121
, Utah Code Annotated 1953
75A-9-122
, Utah Code Annotated 1953
75A-9-123
, Utah Code Annotated 1953
75A-9-124
, Utah Code Annotated 1953
75A-9-125
, Utah Code Annotated 1953
75A-9-126
, Utah Code Annotated 1953
75A-9-127
, Utah Code Annotated 1953
75A-9-128
, Utah Code Annotated 1953
75A-9-129
, Utah Code Annotated 1953
RENUMBERS AND AMENDS:
26B-2-801
, (Renumbered from 75A-3-101, as renumbered and amended by Laws of 
Utah 2024, Chapter 364)
26B-2-802
, (Renumbered from 75A-3-106)
REPEALS:
75A-3-102
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-103
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-104
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-105
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-107
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-201
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-202
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-203
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-204
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-205
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-206
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-207
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-208
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-301
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-302
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-303
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-304
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-305
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-306
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-307
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-308
, as renumbered and amended by Laws of Utah 2024, Chapter 364
75A-3-309
, as renumbered and amended by Laws of Utah 2024, Chapter 364
Be it enacted by the Legislature of the state of Utah:
Section 1, Section 
26B-2-801
, which is renumbered from Section 75A-3-101 is renumbered 
and amended to read:
8. Order for Life Sustaining Treatment
75A-3-101
26B-2-801
. Definitions.
As used in this chapter:
(1)
"Adult" means an individual who is:
(a)
at least 18 years old; or
(b)
an emancipated minor.
(2)
"Advance health care directive":
(a)
includes:
(i)
a designation of an agent to make health care decisions for an adult when the 
adult cannot make or communicate health care decisions; or
(ii)
an expression of preferences about health care decisions;
(b)
may take one of the following forms:
(i)
a written document, voluntarily executed by an adult in accordance with the 
requirements of this chapter; or
(ii)
a witnessed oral statement, made in accordance with the requirements of this 
chapter; and
(c)
does not include an order for life sustaining treatment.
(3)
"Agent" means an adult designated in an advance health care directive to make health 
care decisions for the declarant.
(4)
(2)
"APRN" means an individual who is:
(a)
certified or licensed as an advance practice registered nurse under Subsection 
58-31b-301
(2)(e);
(b)
an independent practitioner; and
(c)
acting within the scope of practice for that individual, as provided by law, rule, and 
specialized certification and training in that individual's area of practice.
(3)
"Capacity" means the same as that term is defined in Section 
75A-9-101
.
(5)
"Best interest" means that the benefits to the individual resulting from a treatment 
outweigh the burdens to the individual resulting from the treatment, taking into account:
(a)
the effect of the treatment on the physical, emotional, and cognitive functions of the 
individual;
(b)
the degree of physical pain or discomfort caused to the individual by the treatment 
or the withholding or withdrawal of treatment;
(c)
the degree to which the individual's medical condition, the treatment, or the 
withholding or withdrawal of treatment, result in a severe and continuing impairment 
of the dignity of the individual by subjecting the individual to humiliation and 
dependency;
(d)
the effect of the treatment on the life expectancy of the individual;
(e)
the prognosis of the individual for recovery with and without the treatment;
(f)
the risks, side effects, and benefits of the treatment, or the withholding or 
withdrawal of treatment; and
(g)
the religious beliefs and basic values of the individual receiving treatment, to the 
extent these may assist the decision maker in determining the best interest.
(6)
"Capacity to appoint an agent" means that the adult understands the consequences of 
appointing a particular individual as agent.
(7)
"Child" means the same as that term is defined in Section 
75-1-201
.
(8)
"Declarant" means an adult who has completed and signed or directed the signing of an 
advance health care directive.
(9)
"Default surrogate" means the adult who may make decisions for an individual when 
either:
(a)
an agent or guardian has not been appointed; or
(b)
an agent is not able, available, or willing to make decisions for an adult.
(10)
(4)
"Emergency medical services provider" means a person that is licensed, 
designated, or certified under Title 53, Chapter 2d, Emergency Medical Services Act.
(11)
"Estate" means the same as that term is defined in Section 
75-1-201
.
(12)
"Generally accepted health care standards":
(a)
is defined only for the purpose of:
(i)
this chapter and does not define the standard of care for any other purpose under 
Utah law; and
(ii)
enabling health care providers to interpret the statutory form set forth in Section 
75A-3-303
; and
(b)
means the standard of care that justifies a provider in declining to provide life 
sustaining care because the proposed life sustaining care:
(i)
will not prevent or reduce the deterioration in the health or functional status of an 
individual;
(ii)
will not prevent the impending death of an individual; or
(iii)
will impose more burden on the individual than any expected benefit to the 
individual.
(13)
(5)
"Guardian" means the same as that term is defined in Section 
75-1-201
.
(14)
(6)
"Health care" means 
any care, treatment, service, or procedure to improve, 
maintain, diagnose, or otherwise affect an individual's physical or mental condition
the 
same as that term is defined in Section 
75A-9-101
.
(15)
"Health care decision":
(a)
means a decision about an adult's health care made by, or on behalf of, an adult, that 
is communicated to a health care provider;
(b)
includes:
(i)
selection and discharge of a health care provider and a health care facility;
(ii)
approval or disapproval of diagnostic tests, procedures, programs of medication, 
and orders not to resuscitate; and
(iii)
directions to provide, withhold, or withdraw artificial nutrition and hydration 
and all other forms of health care; and
(c)
does not include decisions about an adult's financial affairs or social interactions 
other than as indirectly affected by the health care decision.
(16)
"Health care decision making capacity" means an adult's ability to make an informed 
decision about receiving or refusing health care, including:
(a)
the ability to understand the nature, extent, or probable consequences of health 
status and health care alternatives;
(b)
the ability to make a rational evaluation of the burdens, risks, benefits, and 
alternatives of accepting or rejecting health care; and
(c)
the ability to communicate a decision.
(17)
"Health care facility" means:
(a)
a health care facility as defined in Title 26B, Chapter 2, Part 2, Health Care Facility 
Licensing and Inspection; and
(b)
private offices of physicians, dentists, and other health care providers licensed to 
provide health care under Title 58, Occupations and Professions.
(18)
(7)
"Health care provider" means the same as that term is defined in Section 
78B-3-403
, except that "health care provider" does not include an emergency medical 
services provider.
(19)
"Incapacitated" means the same as that term is defined in Section 75-1-201.
(20)
"Incapacity" means the same as that term is defined in Section 
75-1-201
.
(21)
(8)
(a)
"Life sustaining care" means any medical intervention, including 
procedures, administration of medication, or use of a medical device, that maintains 
life by sustaining, restoring, or supplanting a vital function.
(b)
"Life sustaining care" does not include care provided for the purpose of keeping an 
individual comfortable.
(22)
(9)
"Minor" means an individual who:
(a)
is under 18 years old; and
(b)
is not an emancipated minor.
(23)
(10)
"Order for life sustaining treatment" means an order related to life sustaining 
treatment, on a form designated by the Department of Health and Human Services under 
Section 
75-3-106
26B-2-802
, that gives direction to health care providers, health care 
facilities, and emergency medical services providers regarding the specific health care 
decisions of the individual to whom the order relates.
(24)
(11)
"Parent" means the same as that term is defined in Section 
75-1-201
.
(25)
"Personal representative" means the same as that term is defined in Section 
75-1-201
.
(26)
(12)
"Physician" means a physician and surgeon or osteopathic surgeon licensed 
under Title 58, Chapter 67, Utah Medical Practice Act or Chapter 68, Utah Osteopathic 
Medical Practice Act.
(27)
(13)
"Physician assistant" means an individual licensed as a physician assistant under 
Title 58, Chapter 70a, Utah Physician Assistant Act.
(28)
"Reasonably available" means:
(a)
readily able to be contacted without undue effort; and
(b)
willing and able to act in a timely manner considering the urgency of the 
circumstances.
(29)
"State" means the same as that term is defined in Section 
75-1-201
.
(30)
(14)
"Substituted judgment" means the standard to be applied by a surrogate when 
making a health care decision for an adult who previously had the capacity to make 
health care decisions, which requires the surrogate to consider:
(a)
specific preferences expressed by the adult:
(i)
when the adult had the capacity to make health care decisions; and
(ii)
at the time the decision is being made;
(b)
the surrogate's understanding of the adult's health care preferences;
(c)
the surrogate's understanding of what the adult would have wanted under the 
circumstances; and
(d)
to the extent that the preferences described in Subsections 
(30)(a)
(14)(a)
 through (c) 
are unknown, the best interest of the adult.
(31)
(15)
"Surrogate" means 
a health care decision maker who is:
the same as that term is 
defined in Section 
75A-9-101
.
(a)
an appointed agent;
(b)
a default surrogate under the provisions of Section 
75A-3-203
; or
(c)
a guardian
.
(32)
"Trust" means the same as that term is defined in Section 
75-1-201
.
(33)
"Will" means the same as that term is defined in Section 
75-1-201
.
Section 2, Section 
26B-2-802
, which is renumbered from Section 75A-3-106 is renumbered 
and amended to read:
75A-3-106
26B-2-802
. Order for life sustaining treatment.
(1)
An order for life sustaining treatment may be created by or on behalf of an individual as 
described in this section.
(2)
An order for life sustaining treatment shall, in consultation with the individual 
authorized to consent to the order pursuant to this section, be prepared by:
(a)
the physician, APRN, or physician assistant of the individual to whom the order for 
life sustaining treatment relates; or
(b)
a health care provider who:
(i)
is acting under the supervision of an individual described in Subsection (2)(a); and
(ii)
is:
(A)
a nurse, licensed under Title 58, Chapter 31b, Nurse Practice Act;
(B)
a physician assistant, licensed under Title 58, Chapter 70a, Utah Physician 
Assistant Act;
(C)
a mental health professional, licensed under Title 58, Chapter 60, Mental 
Health Professional Practice Act; or
(D)
another health care provider, designated by rule as described in Subsection 
(10).
(3)
An order for life sustaining treatment shall be signed:
(a)
personally, by the physician, APRN, or physician assistant of the individual to whom 
the order for life sustaining treatment relates; and
(b)
(i)
if the individual to whom the order for life sustaining treatment relates is an 
adult with 
health care decision making 
capacity, by:
(A)
the individual; or
(B)
an adult who is directed by the individual to sign the order for life sustaining 
treatment on behalf of the individual;
(ii)
if the individual to whom the order for life sustaining treatment relates is an adult 
who lacks 
health care decision making 
capacity, by:
(A)
the surrogate with the highest priority under Section 
75A-3-206
75A-9-111
;
(B)
the majority of the class of surrogates with the highest priority under Section 
75A-3-206
75A-9-111
; or
(C)
an individual directed to sign the order for life sustaining treatment by, and on 
behalf of, the individuals described in Subsection (3)(b)(ii)(A) or (B); or
(iii)
if the individual to whom the order for life sustaining treatment relates is a 
minor, by a parent or guardian of the minor.
(4)
If an order for life sustaining treatment relates to a minor and directs that life sustaining 
treatment be withheld or withdrawn from the minor, the order shall include a 
certification by two physicians that, in their clinical judgment, an order to withhold or 
withdraw life sustaining treatment is in the best interest of the minor.
(5)
An order for life sustaining treatment:
(a)
shall be in writing, on a form designated by the Department of Health and Human 
Services;
(b)
shall state the date on which the order for life sustaining treatment was made;
(c)
may specify the level of life sustaining care to be provided to the individual to whom 
the order relates; and
(d)
may direct that life sustaining care be withheld or withdrawn from the individual to 
whom the order relates.
(6)
A health care provider or emergency medical service provider, licensed or certified 
under Title 53, Chapter 2d, Emergency Medical Services Act, is immune from civil or 
criminal liability, and is not subject to discipline for unprofessional conduct, for:
(a)
complying with an order for life sustaining treatment in good faith; or
(b)
providing life sustaining treatment to an individual when an order for life sustaining 
treatment directs that the life sustaining treatment be withheld or withdrawn.
(7)
To the extent that the provisions of an order for life sustaining treatment described in 
this section conflict with the provisions of an advance health care directive made under 
Section 
75A-3-301
75A-9-906
, the provisions of the order for life sustaining treatment 
take precedence.
(8)
An adult, or a parent or guardian of a minor, may revoke an order for life sustaining 
treatment by:
(a)
orally informing emergency service personnel;
(b)
writing "void" across the order for life sustaining treatment form;
(c)
burning, tearing, or otherwise destroying or defacing:
(i)
the order for life sustaining treatment form; or
(ii)
a bracelet or other evidence of the order for life sustaining treatment;
(d)
asking another adult to take the action described in this Subsection (8) on the 
individual's behalf;
(e)
signing or directing another adult to sign a written revocation on the individual's 
behalf;
(f)
stating, in the presence of an adult witness, that the individual wishes to revoke the 
order; or
(g)
completing a new order for life sustaining treatment.
(9)
(a)
Except as provided in Subsection (9)(c), a surrogate for an adult who lacks 
health 
care decision making 
capacity may only revoke an order for life sustaining treatment 
if the revocation is consistent with the substituted judgment standard.
(b)
Except as provided in Subsection (9)(c), a surrogate who has authority under this 
section to sign an order for life sustaining treatment may revoke an order for life 
sustaining treatment, in accordance with Subsection (9)(a), by:
(i)
signing a written revocation of the order for life sustaining treatment; or
(ii)
completing and signing a new order for life sustaining treatment.
(c)
A surrogate may not revoke an order for life sustaining treatment during the period 
of time beginning when an emergency service provider is contacted for assistance, 
and ending when the emergency ends.
(10)
(a)
The Department of Health and Human Services shall make rules, in accordance 
with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to:
(i)
create the forms and systems described in this section; and
(ii)
develop uniform instructions for the form established in Section 
75A-3-303
75A-9-110
.
(b)
The Department of Health and Human Services may make rules, in accordance with 
Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to designate health care 
professionals, in addition to those described in Subsection (2)(b)(ii), who may 
prepare an order for life sustaining treatment.
(c)
The Department of Health and Human Services may assist others with training of 
health care professionals regarding this chapter.
(11)
(a)
Notwithstanding any other provision of this section:
(i)
the provisions of Title 46, Chapter 4, Uniform Electronic Transactions Act, apply 
to any signature required on the order for life sustaining treatment; and
(ii)
a verbal confirmation satisfies the requirement for a signature from an individual 
under Subsection (3)(b)(ii) or (iii), if:
(A)
requiring the individual described in Subsection (3)(b)(i)(B), (ii), or (iii) to 
sign the order for life sustaining treatment in person or electronically would 
require significant difficulty or expense; and
(B)
a licensed health care provider witnesses the verbal confirmation and signs the 
order for life sustaining treatment attesting that the health care provider 
witnessed the verbal confirmation.
(b)
The health care provider described in Subsection (11)(a)(ii)(B):
(i)
may not be the same individual who signs the order for life sustaining treatment 
under Subsection (3)(a); and
(ii)
shall verify, in accordance with HIPAA as defined in Section 
26B-3-126
, the 
identity of the individual who is providing the verbal confirmation.
Section 3, Section 
75A-9-101
 is enacted to read:
9. 
UNIFORM HEALTH CARE DECISIONS ACT
75A-9-101. Definitions.
As used in this chapter:
(1)
(a)
"Advance health care directive" means a power of attorney for health care, health 
care instruction, or both.
(b)
"Advance health care directive" includes an advance mental health care directive.
(2)
"Advance mental health care" directive means a power of attorney for health care, 
health care instruction, or both, created under Section 
75A-9-108
.
(3)
(a)
"Agent" means an individual appointed under a power of attorney for health care 
to make a health care decision for the individual who made the appointment.
(b)
"Agent" includes a co-agent or alternate agent appointed under Section 
75A-9-119
.
(4)
"Capacity" means having capacity under Section 
75A-9-102
.
(5)
"Cohabitant" means each of two individuals who have been living together as a couple 
for at least one year after each became an adult or was emancipated and who are not 
married to each other.
(6)
"Default surrogate" means an individual authorized under Section 
75A-9-111
 to make a 
health care decision for another individual.
(7)
"Electronic" means relating to technology having electrical, digital, magnetic, wireless, 
optical, electromagnetic, or similar capabilities.
(8)
"Emergency medical services provider" means a person that is licensed, designated, or 
certified under Title 53, Chapter 2d, Emergency Medical Services Act.
(9)
"Family member" means a spouse, adult child, parent, or grandparent, or an adult 
descendant of a spouse, child, parent, or grandparent.
(10)
(a)
"Guardian" means a person appointed under other law by a court to make 
decisions regarding the personal affairs of an individual, which may include health 
care decisions.
(b)
"Guardian" does not include a guardian ad litem.
(11)
(a)
"Health care" means care or treatment or a service or procedure to maintain, 
monitor, diagnose, or otherwise affect an individual's physical or mental illness, 
injury, or condition.
(b)
"Health care" includes mental health care.
(12)
"Health care decision" means a decision made by an individual or the individual's 
surrogate regarding the individual's health care, including:
(a)
selection or discharge of a health care professional or health care institution;
(b)
approval or disapproval of a diagnostic test, surgical procedure, medication, 
therapeutic intervention, or other health care; and
(c)
direction to provide, withhold, or withdraw artificial nutrition or hydration, 
mechanical ventilation, or other health care.
(13)
"Health care institution" means a facility or agency licensed, certified, or otherwise 
authorized or permitted by other law to provide health care in this state in the ordinary 
course of business.
(14)
(a)
"Health care instruction" means a direction, whether or not in a record, made by 
an individual that indicates the individual's goals, preferences, or wishes concerning 
the provision, withholding, or withdrawal of health care.
(b)
"Health care instruction" includes a direction intended to be effective if a specified 
condition arises.
(15)
"Health care professional" means a physician or other individual licensed, certified, or 
otherwise authorized or permitted by other law of this state to provide health care in this 
state in the ordinary course of business or the practice of the physician's or individual's 
profession.
(16)
"Individual" means an adult or emancipated minor.
(17)
"Mental health care" means care or treatment or a service or procedure to maintain, 
monitor, diagnose, or otherwise affect an individual's mental illness or other psychiatric, 
psychological, or psychosocial condition.
(18)
"Nursing home" means a nursing facility as defined in Section 1919(a)(1) of the Social 
Security Act, 42 U.S.C. Sec. 1396r(a)(1), as amended or skilled nursing facility as 
defined in Section 1819(a)(1) of the Social Security Act, 42 U.S.C. Sec. 1395i3(a)(1), as 
amended.
(19)
"Person" means an individual, estate, business or nonprofit entity, government or 
governmental subdivision, agency, or instrumentality, or other legal entity.
(20)
"Person interested in the welfare of the individual" means:
(a)
the individual's surrogate;
(b)
a family member of the individual;
(c)
the cohabitant of the individual;
(d)
a public entity providing health care case management or protective services to the 
individual;
(e)
a person appointed under other law to make decisions for the individual under a 
power of attorney for finances; or
(f)
a person that has an ongoing personal or professional relationship with the individual, 
including a person that has provided educational or health care services or supported 
decision making to the individual.
(21)
"Physician" means an individual licensed to practice as a physician or osteopath under 
Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah 
Osteopathic Medical Practice Act.
(22)
"Power of attorney for health care" means a record in which an individual appoints an 
agent to make health care decisions for the individual.
(23)
"Reasonably available" means being able to be contacted without undue effort and 
being willing and able to act in a timely manner considering the urgency of an 
individual's health care situation. When used to refer to an agent or default surrogate, the 
term includes being willing and able to comply with the duties under Section 
75A-9-116
in a timely manner considering the urgency of an individual's health care situation.
(24)
"Record" means information:
(a)
inscribed on a tangible medium; or
(b)
stored in an electronic or other medium and retrievable in perceivable form.
(25)
"Responsible health care professional" means:
(a)
a health care professional designated by an individual or the individual's surrogate to 
have primary responsibility for the individual's health care or for overseeing a course 
of treatment; or
(b)
in the absence of a designation under Subsection 
(25)(a)
 or, if the professional 
designated under Subsection 
(25)(a)
 is not reasonably available, a health care 
professional who has primary responsibility for overseeing the individual's health 
care or for overseeing a course of treatment.
(26)
"Sign" means, with present intent to authenticate or adopt a record:
(a)
execute or adopt a tangible symbol; or
(b)
attach to or logically associate with the record an electronic symbol, sound, or 
process.
(27)
"State" means a state of the United States, the District of Columbia, Puerto Rico, the 
United States Virgin Islands, any other territory or possession subject to the jurisdiction 
of the United States, or a federally recognized Indian tribe.
(28)
"Supported decision making" means assistance, from one or more persons of an 
individual's choosing, that helps the individual make or communicate a decision, 
including by helping the individual understand the nature and consequences of the 
decision.
(29)
"Surrogate" means:
(a)
an agent;
(b)
a default surrogate; or
(c)
a guardian authorized to make health care decisions.
Section 4, Section 
75A-9-102
 is enacted to read:
75A-9-102. Capacity.
(1)
An individual has capacity for the purpose of this chapter if the individual:
(a)
is willing and able to communicate a decision independently or with appropriate 
services, technological assistance, supported decision making, or other reasonable 
accommodation; and
(b)
in making or revoking:
(i)
a health care decision, understands the nature and consequences of the decision, 
including the primary risks and benefits of the decision;
(ii)
a health care instruction, understands the nature and consequences of the 
instruction, including the primary risks and benefits of the choices expressed in 
the instruction; and
(iii)
an appointment of an agent under a health care power of attorney or 
identification of a default surrogate under Section 
75A-9-111
, recognizes the 
identity of the individual being appointed or identified and understands the 
general nature of the relationship of the individual making the appointment or 
identification with the individual being appointed or identified.
(2)
The right of an individual who has capacity to make a decision about the individual's 
health care is not affected by whether the individual creates or revokes an advance 
health care directive.
Section 5, Section 
75A-9-103
 is enacted to read:
75A-9-103. Presumption of capacity -- Overcoming presumption.
(1)
An individual is presumed to have capacity to make or revoke a health care decision, 
health care instruction, and power of attorney for health care unless:
(a)
a court has found the individual lacks capacity to do so; or
(b)
the presumption is rebutted under Subsection (2).
(2)
Subject to Sections 
75A-9-104
 and 
75A-9-105
, a presumption under Subsection (1) may 
be rebutted by a finding that the individual lacks capacity:
(a)
subject to Subsection (3), made on the basis of a contemporaneous examination by 
any of the following:
(i)
a physician;
(ii)
a psychologist licensed or otherwise authorized to practice in this state;
(iii)
an individual with training and expertise in the finding of lack of capacity who is 
licensed or otherwise authorized to practice in this state as:
(A)
a physician assistant; or
(B)
an advanced practice registered nurse; or
(iv)
a responsible health care professional not described in Subsections 
(2)(a)
(i) 
through (iii) if:
(A)
the individual about whom the finding is to be made is experiencing a health 
condition requiring a decision regarding health care treatment to be made 
promptly to avoid loss of life or serious harm to the health of the individual; 
and
(B)
an individual described in Subsections 
(2)(a)(i)
 through (iii) is not reasonably 
available;
(b)
made in accordance with accepted standards of the profession and the scope of 
practice of the individual making the finding and to a reasonable degree of certainty; 
and
(c)
documented in a record signed by the individual making the finding that includes an 
opinion of the cause, nature, extent, and probable duration of the lack of capacity.
(3)
The finding under Subsection (2) may not be made by:
(a)
a family member of the individual presumed to have capacity;
(b)
the cohabitant of the individual or a descendant of the cohabitant; or
(c)
the individual's surrogate, a family member of the surrogate, or a descendant of the 
surrogate.
(4)
If the finding under Subsection (2) was based on a condition the individual no longer 
has or a responsible health care professional subsequently has good cause to believe the 
individual has capacity, the individual is presumed to have capacity unless a court finds 
the individual lacks capacity or the presumption is rebutted under Subsection 
(2)
.
Section 6, Section 
75A-9-104
 is enacted to read:
75A-9-104. Notice of finding of lack of capacity -- Right to object.
(1)
As soon as reasonably feasible, an individual who makes a finding under Subsection 
75A-9-103(2)
 shall inform the individual about whom the finding was made or the 
individual's responsible health care professional of the finding.
(2)
 As soon as reasonably feasible, a responsible health care professional who is informed 
of a finding under Subsection 
75A-9-103(2)
 shall inform the individual about whom the 
finding was made and the individual's surrogate.
(3)
An individual found under Subsection 
75A-9-103(2)
 to lack capacity may object to the 
finding:
(a)
by orally informing a responsible health care professional;
(b)
in a record provided to a responsible health care professional or the health care 
institution in which the individual resides or is receiving care; or
(c)
by another act that clearly indicates the individual's objection.
(4)
If the individual objects under Subsection (3), the finding under Subsection 
75A-9-103(2)
 is not sufficient to rebut a presumption of capacity in Subsection 
75A-9-103(1)
 and the individual must be treated as having capacity unless:
(a)
the individual withdraws the objection;
(b)
a court finds the individual lacks the presumed capacity;
(c)
the individual is experiencing a health condition requiring a decision regarding health 
care treatment to be made promptly to avoid imminent loss of life or serious harm to 
the health of the individual; or
(d)
subject to Subsection (5), the finding is confirmed by a second finding made by an 
individual authorized under Subsection 
75A-9-103(2)(a)
 who:
(i)
did not make the first finding;
(ii)
is not a family member of the individual who made the first finding; and
(iii)
is not the cohabitant of the individual who made the first finding or a descendant 
of the cohabitant.
(5)
A second finding that the individual lacks capacity under Subsection 
(4)(d)
 is not 
sufficient to rebut the presumption of capacity if the individual is requesting the 
provision or continuation of life-sustaining treatment and the finding is being used to 
make a decision to withhold or withdraw the treatment.
(6)
 As soon as reasonably feasible, a health care professional who is informed of an 
objection under Subsection 
(3)
 shall:
(a)
communicate the objection to a responsible health care professional; and
(b)
document the objection and the date of the objection in the individual's medical 
record or communicate the objection and the date of the objection to an administrator 
with responsibility for medical records of the health care institution providing health 
care to the individual, who shall document the objection and the date of the objection 
in the individual's medical record.
Section 7, Section 
75A-9-105
 is enacted to read:
75A-9-105. Judicial review of finding of lack of capacity.
(1)
An individual found under Subsection 
75A-9-103(2)
 to lack capacity, a responsible 
health care professional, the health care institution providing health care to the 
individual, or a person interested in the welfare of the individual may petition the court 
in the county in which the individual resides or is located to determine whether the 
individual lacks capacity.
(2)
(a)
The court in which a petition under Subsection (1) is filed shall appoint legal 
counsel to represent the individual if the individual does not have legal counsel.
(b)
The court shall hear the petition as soon as possible.
(c)
As soon as possible the court shall determine whether the individual lacks capacity.
(d)
The court may determine the individual lacks capacity only if the court finds by clear 
and convincing evidence that the individual lacks capacity.
Section 8, Section 
75A-9-106
 is enacted to read:
75A-9-106. Health care instructions.
(1)
An individual may create a health care instruction that expresses the individual's 
preferences for future health care, including preferences regarding:
(a)
health care professionals or health care institutions;
(b)
how a health care decision will be made and communicated;
(c)
persons that should or should not be consulted regarding a health care decision;
(d)
a person to serve as guardian for the individual if one is appointed; and
(e)
an individual to serve as a default surrogate.
(2)
A health care professional to whom an individual communicates or provides an 
instruction under Subsection (1) shall document the instruction and the date of the 
instruction in the individual's medical record or communicate the instruction and date of 
the instruction to an administrator with responsibility for medical records of the health 
care institution providing health care to the individual, who shall document the 
instruction and the date of the instruction in the individual's medical record.
(3)
A health care instruction made by an individual that conflicts with an earlier health care 
instruction made by the individual, including an instruction documented in a medical 
order, revokes the earlier instruction to the extent of the conflict.
(4)
A health care instruction may be in the same record as a power of attorney for health 
care.
Section 9, Section 
75A-9-107
 is enacted to read:
75A-9-107. Power of attorney for health care.
(1)
An individual may create a power of attorney for health care to appoint an agent to 
make health care decisions for the individual.
(2)
An individual is disqualified from acting as agent for an individual who lacks capacity 
to make health care decisions if:
(a)
a court finds that the potential agent poses a danger to the individual's well-being, 
even if the court does not issue a protective order against the potential agent; or
(b)
the potential agent is an owner, operator, employee, or contractor of a nursing home 
or assisted living facility in which the individual resides or is receiving care, unless 
the owner, operator, employee, or contractor is a family member of the individual, 
the cohabitant of the individual, or a descendant of the cohabitant.
(3)
A health care decision made by an agent is effective without judicial approval.
(4)
A power of attorney for health care must be in a record, signed by the individual 
creating the power, and signed by an adult witness who:
(a)
reasonably believes the act of the individual to create the power of attorney is 
voluntary and knowing;
(b)
is not:
(i)
the agent appointed by the individual;
(ii)
the agent's spouse or cohabitant; or
(iii)
if the individual resides or is receiving care in a nursing home or assisted living 
facility, the owner, operator, employee, or contractor of the nursing home or 
assisted living facility; and
(c)
is present when the individual signs the power of attorney or when the individual 
represents that the power of attorney reflects the individual's wishes.
(5)
A witness under Subsection (4) is considered present if the witness and the individual 
are:
(a)
physically present in the same location;
(b)
using electronic means that allow for real time audio and visual transmission and 
communication in real time to the same extent as if the witness and the individual 
were physically present in the same location; or
(c)
able to speak to and hear each other in real time through audio connection if:
(i)
the identity of the individual is personally known to the witness; or
(ii)
the witness is able to authenticate the identity of the individual by receiving 
accurate answers from the individual that enable the authentication.
(6)
A power of attorney for health care may include a health care instruction.
Section 10, Section 
75A-9-108
 is enacted to read:
75A-9-108. Advance mental health care directive.
(1)
(a)
An individual may create an advance health care directive that addresses only 
mental health care for the individual.
(b)
The directive may include a health care instruction, a power of attorney for health 
care, or both.
(2)
A health care instruction under this section may include the individual's:
(a)
general philosophy and objectives regarding mental health care; or
(b)
specific goals, preferences, and wishes regarding the provision, withholding, or 
withdrawal of a form of mental health care, including:
(i)
preferences regarding professionals, programs, and facilities;
(ii)
admission to a mental-health facility, including duration of admission;
(iii)
preferences regarding medications;
(iv)
refusal to accept a specific type of mental health care, including a medication; and
(v)
preferences regarding crisis intervention.
(3)
A power of attorney for health care under this section may appoint an agent to make 
decisions only for mental health care.
Section 11, Section 
75A-9-109
 is enacted to read:
75A-9-109. Relationship of advance mental health care directive and other 
advance health care directive.
(1)
If a direction in an advance mental health care directive of an individual conflicts with a 
direction in another advance health care directive of the individual, the later direction 
revokes the earlier direction to the extent of the conflict.
(2)
(a)
An appointment of an agent to make decisions only for mental health care for an 
individual does not revoke an earlier appointment of an agent to make other health 
care decisions for the individual.
(b)
A later appointment revokes the authority of an agent under the earlier appointment 
to make decisions about mental health care unless otherwise specified in the power of 
attorney making the later appointment.
(3)
An appointment of an agent to make health care decisions for an individual other than 
decisions about mental health care made after appointment of an agent authorized to 
make only mental health care decisions does not revoke the appointment of the agent 
authorized to make only mental health care decisions.
Section 12, Section 
75A-9-110
 is enacted to read:
75A-9-110. Optional form.
The following form may be used to create an advance health care directive:
ADVANCE HEALTH CARE DIRECTIVE
HOW YOU CAN USE THIS FORM
You can use this form if you wish to name someone to make health care decisions for you 
in case you cannot make decisions for yourself. This is called giving the person a power of 
attorney for health care. This person is called your Agent.
You can also use this form to state your wishes, preferences, and goals for health care, and 
to say if you want to be an organ donor after you die.
YOUR NAME AND DATE OF BIRTH
Name:
Date of birth:
PART A: NAMING AN AGENT
This part lets you name someone else to make health care decisions for you. You may leave 
any item blank.
1. NAMING AN AGENT
I want the following person to make health care decisions for me if I cannot make 
decisions for myself:
Name:
Optional contact information (it is helpful to include information such as address, phone, 
and email):
2. NAMING AN ALTERNATE AGENT 
I want the following person to make health care decisions for me if I cannot and my 
Agent is not able or available to make them for me:
Name:
Optional contact information (it is helpful to include information such as address, phone, 
and email):
3. LIMITING YOUR AGENT'S AUTHORITY
I give my Agent the power to make all health care decisions for me if I cannot make 
those decisions for myself, except the following:
(If you do not add a limitation here, your Agent will be able to make all health care 
decisions that an Agent is permitted to make under state law.)
PART B: HEALTH CARE INSTRUCTIONS
This part lets you state your priorities for health care and to state types of health care you 
do and do not want.
1. INSTRUCTIONS ABOUT LIFE-SUSTAINING TREATMENT
This section gives you the opportunity to say how you want your Agent to act while making 
decisions for you. You may mark or initial each choice. You also may leave any choice blank.
Treatment. Medical treatment needed to keep me alive but not needed for comfort or any 
other purpose should (mark or initial all that apply):
(____) Always be given to me. (If you mark or initial this choice, you should not mark 
or initial other choices in this "treatment" section.)
(____) Not be given to me if I have a condition that is not curable and is expected to 
cause my death soon, even if treated.
(____) Not be given to me if I am unconscious and I am not expected to be conscious 
again.
(____) Not be given to me if I have a medical condition from which I am not expected 
to recover that prevents me from communicating with people I care about, caring for myself, 
and recognizing family and friends.
(____) Other (write what you want or do not want):
Food and liquids. If I can't swallow and staying alive requires me to get food or liquids 
through a tube or other means for the rest of my life, then food or liquids should (mark or 
initial all that apply):
(____) Always be given to me. (If you mark or initial this choice, you should not mark 
or initial other choices in this food and liquids section.)
(____) Not be given to me if I have a condition that is not curable and is expected to 
cause me to die soon, even if treated.
(____) Not be given to me if I am unconscious and am not expected to be conscious 
again.
(____) Not be given to me if I have a medical condition from which I am not expected 
to recover that prevents me from communicating with people I care about, caring for myself, 
and recognizing family and friends.
(____) Other (write what you want or do not want):
Pain relief. If I am in significant pain, care that will keep me comfortable but is likely to 
shorten my life should (mark or initial all that apply):
(____) Always be given to me. (If you mark or initial this choice, you should not mark 
or initial other choices in this pain relief section.)
(____) Never be given to me. (If you mark or initial this choice, you should not mark or 
initial other choices in this pain relief section.)
(____) Be given to me if I have a condition that is not curable and is expected to cause 
me to die soon, even if treated.
(____) Be given to me if I am unconscious and am not expected to be conscious again.
(____) Be given to me if I have a medical condition from which I am not expected to 
recover that prevents me from communicating with people I care about, caring for myself, and 
recognizing family and friends.
(____) Other (write what you want or do not want):
2. MY PRIORITIES
You can use this section to indicate what is important to you, and what is not important to 
you. This information can help your Agent make decisions for you if you cannot. It also helps 
others understand your preferences.
You may mark or initial each choice. You also may leave any choice blank.
Staying alive as long as possible even if I have substantial physical limitations is:
(____) Very important
(____) Somewhat important
(____) Not important
Staying alive as long as possible even if I have substantial mental limitations is:
(____) Very important
(____) Somewhat important
(____) Not important
Being free from significant pain is:
(____) Very important
(____) Somewhat important
(____) Not important
Being independent is:
(____) Very important
(____) Somewhat important
(____) Not important
Having my Agent talk with my family before making decisions about my care is:
(____) Very important
(____) Somewhat important
(____) Not important
Having my Agent talk with my friends before making decisions about my care is:
(____) Very important
(____) Somewhat important
(____) Not important
3. OTHER INSTRUCTIONS
You can write in this section more information about your goals, values, and preferences 
for treatment, including care you want or do not want. You can also use this section to name 
anyone who you do not want to make decisions for you under any conditions.
PART C: OPTIONAL SPECIAL POWERS AND GUIDANCE
This part lets you give your Agent additional powers and provide more guidance about your 
wishes. You may mark or initial each choice. You also may leave any choice blank.
1. OPTIONAL SPECIAL POWERS
My Agent can do the following things ONLY if I have marked or initialed them below:
(____) Admit me as a voluntary patient to a facility for mental health treatment for 
up to _____ days (write in the number of days you want like 7, 14, 30, or another number).
(If I do not mark or initial this choice, my Agent MAY NOT admit me as a voluntary 
patient to this type of facility.)
(____) Place me in a nursing home for more than 100 days even if my needs can be 
met somewhere else, I am not terminally ill, and I object.
(If I do not mark or initial this choice, my Agent MAY NOT do this.)
2. ACCESS TO MY HEALTH INFORMATION
My Agent may obtain, examine, and share information about my health needs and health 
care if I am not able to make decisions for myself. If I mark or initial below, my Agent may 
also do that at any time my Agent thinks it will help me.
(____) I give my Agent permission to obtain, examine, and share information about 
my health needs and health care whenever my Agent thinks it will help me.
3. FLEXIBILITY FOR MY AGENT
Mark or initial below if you want to give your Agent flexibility in following instructions 
you provide in this form. If you do not, your Agent must follow the instructions even if your 
Agent thinks something else would be better for you.
(____) I give my Agent permission to be flexible in applying these instructions if my 
Agent thinks it would be in my best interest based on what my Agent knows about me.
4. NOMINATION OF GUARDIAN
You can say who you would want as your guardian if you needed one. A guardian is a 
person appointed by a court to make decisions for someone who cannot make decisions. 
Filling this out does NOT mean you want or need a guardian.
If a court appoints a guardian to make personal decisions for me, I want the court to 
choose:
(____) My Agent named in this form. If my Agent cannot be a guardian, I want the 
Alternate Agent named in this form.
(____) Other (write who you would want and their contact information):
PART D: ORGAN DONATION
This part lets you donate your organs after you die. You may leave any item blank.
1. DONATION
You may mark or initial only one choice.
(____) I donate my organs, tissues, and other body parts after I die, even if it 
requires maintaining treatments that conflict with other instructions I have put in this form, 
EXCEPT for those I list below (list any body parts you do NOT want to donate):
(____) I do not want my organs, tissues, or body parts donated to anybody for any 
reason. (If you mark or initial this choice, you should skip the purpose of donation section.)
2. PURPOSE OF DONATION
You may mark or initial all that apply. (If you do not mark or initial any of the purposes 
below, your donation can be used for all of them.)
Organs, tissues, or body parts that I donate may be used for:
(____) Transplant
(____) Therapy
(____) Research
(____) Education
(____) All of the above
PART E: SIGNATURES
YOUR SIGNATURE
Sign your name:
Today's date:
City/Town/Village and State (optional):
SIGNATURE OF A WITNESS
You need a witness if you are using this form to name an Agent. The witness must be an 
adult and cannot be the person you are naming as Agent or the Agent's spouse or someone the 
Agent lives with as a couple. If you live or are receiving care in a nursing home, the witness 
cannot be an employee or contractor of the home or someone who owns or runs the home.
Name of Witness:
Signature of Witness: (Only sign as a witness if you think the person signing above is doing 
it voluntarily.)
Date witness signed:
PART F: INFORMATION FOR AGENTS
1. If this form names you as an Agent, you can make decisions about health care for the 
person who named you when the person cannot make their own.
2. If you make a decision for the person, follow any instructions the person gave, including 
any in this form.
3. If you do not know what the person would want, make the decision that you think is in 
the person's best interest. To figure out what is in the person's best interest, consider the 
person's values, preferences, and goals if you know them or can learn them. Some of these 
preferences may be in this form. You should also consider any behavior or communication 
from the person that indicates what the person currently wants.
4. If this form names you as an Agent, you can also get and share the person's health 
information. But unless the person has said so in this form, you can get or share this 
information only when the person cannot make decisions about the person's health care.
Section 13, Section 
75A-9-111
 is enacted to read:
75A-9-111. Default surrogate.
(1)
A default surrogate may make a health care decision for an individual who lacks 
capacity to make health care decisions and for whom an agent, or guardian authorized to 
make health care decisions, has not been appointed or is not reasonably available.
(2)
Unless the individual has an advance health care directive that indicates otherwise, a 
member of the following classes, in descending order of priority, who is reasonably 
available and not disqualified under Section 
75A-9-113
, may act as a default surrogate 
for the individual:
(a)
an adult the individual has identified, other than in a power of attorney for health 
care, to make a health care decision for the individual if the individual cannot make 
the decision;
(b)
the individual's spouse unless:
(i)
a petition for annulment, divorce, dissolution of marriage, legal separation, or 
termination has been filed and not dismissed or withdrawn;
(ii)
a decree of annulment, divorce, dissolution of marriage, legal separation, or 
termination has been issued;
(iii)
the individual and the spouse have agreed in a record to a legal separation; or
(iv)
the spouse has willfully deserted the individual for more than one year;
(c)
the individual's adult child or parent;
(d)
the individual's cohabitant;
(e)
the individual's adult sibling;
(f)
the individual's adult grandchild or grandparent;
(g)
an adult not listed in Subsections (2)(a) through (f) who has assisted the individual 
with supported decision making routinely during the preceding six months;
(h)
the individual's adult stepchild not listed in Subsections (2)(a) through (g) whom the 
individual actively parented during the stepchild's minor years and with whom the 
individual has an ongoing relationship;
(i)
an adult not listed in Subsections (2)(a) through (h) who has exhibited special care 
and concern for the individual and is familiar with the individual's personal values; or
(j)
a physician designated in accordance with Subsection (6).
(3)
(a)
A responsible health care professional may require an individual who assumes 
authority to act as a default surrogate to provide a declaration in a record under 
penalty of perjury stating facts and circumstances reasonably sufficient to establish 
the authority.
(b)
The Department of Health and Human Services shall create a uniform form to be 
used in accordance with Subsection (3)(a).
(4)
If a responsible health care professional reasonably determines that an individual who 
assumed authority to act as a default surrogate is not willing or able to comply with a 
duty under Section 
75A-9-116
 or fails to comply with the duty in a timely manner, the 
professional may recognize the individual next in priority under Subsection (2) as the 
default surrogate.
(5)
A health care decision made by a default surrogate is effective without judicial approval.
(6)
If an individual resides in or is receiving care in a health care institution, and is 
determined to lack capacity to make a health care decision, the responsible health care 
professional may designate a willing physician to make the decision on behalf of the 
individual if:
(a)
the responsible health care professional, or person acting under the supervision of the 
responsible health care professional, after using best efforts cannot identify and 
locate:
(i)
an agent who has been appointed by the individual to make health care decisions;
(ii)
a guardian authorized to make health care decisions for the individual; or
(iii)
a default surrogate under Subsections 
(2)
(a) through (i);
(b)
(i)
the responsible health care professional has consulted with and obtained a 
consensus on the designation with the medical ethics committee of the health care 
institution where the individual resides or is receiving care; or
(ii)
if no medical ethics committee exists within the health care institution, has 
consulted with and obtained consensus from a similar entity utilized by the health 
care institution;
(c)
the physician designated to act as default surrogate under this subsection is not:
(i)
providing health care to the individual;
(ii)
under the actual or constructive authority of the responsible health care 
professional;
(iii)
a family member or cohabitant of the responsible health care professional; or
(iv)
disqualified from acting as default surrogate under Section 
75A-9-113
;
(d)
the responsible health care professional informs the individual of the designation of a 
willing physician, the identity of the designated physician, and of the individual's 
right to object to the designation; and
(e)
the identity of the physician designated by the responsible health care professional is 
documented in the individual's medical record.
(7)
The power of a physician designated under Subsection (6) to act as default surrogate 
terminates if:
(a)
a person listed in Subsections (2)(a) through (i) is identified and located and is 
reasonably available and willing to serve as default surrogate;
(b)
the individual no longer is residing in or receiving care from the health care 
institution; or
(c)
the conditions in Subsection (1) do not exist.
(8)
If the authority of the responsible health care professional to make the designation under 
Subsection (6) or the authority of the physician designated by the responsible health care 
professional to make a health care decision for the individual terminates for any reason, 
including a reason designated in Subsection (7), the responsible health care professional 
shall document the termination and the reason in the individual's medical record.
(9)
In making a health care decision on behalf of the individual, a physician designated to 
act as default surrogate under Subsection (6):
(a)
shall comply with the duties of a default surrogate set forth in Section 
75A-9-116
; and
(b)
may consult with the medical ethics committee or similar entity and rely on the 
committee or entity's evaluation of the individual's best interest if the goals, 
preferences, and wishes of the individual regarding a health care decision are not 
known or reasonably ascertainable by the physician.
Section 14, Section 
75A-9-112
 is enacted to read:
75A-9-112. Disagreement among default surrogates.
(1)
A default surrogate who assumes authority under Section 
75A-9-111
 shall inform a 
responsible health care professional if two or more members of a class under Subsection 
75A-9-111(2)
 have assumed authority to act as default surrogates and the members do 
not agree on a health care decision.
(2)
A responsible health care professional shall comply with the decision of a majority of 
the members of the class with highest priority under Subsection 
75A-9-111(2)
 who have 
communicated their views to the professional and the professional reasonably believes 
are acting consistent with their duties under Section 
75A-9-116
.
(3)
(a)
If a responsible health care professional is informed that the members of the class 
who have communicated their views to the professional are evenly divided 
concerning the health care decision, the default surrogate who assumes authority 
under Section 
75A-9-111
 shall make a reasonable effort to solicit the views of 
members of the class who are reasonably available but have not yet communicated 
their views to the professional.
(b)
The professional, after the solicitation, shall comply with the decision of a majority 
of the members who have communicated their views to the professional and the 
professional reasonably believes are acting consistent with their duties under Section 
75A-9-116
.
(4)
If the class remains evenly divided after the effort is made under Subsection (3), the 
health care decision must be made as provided by other law of this state regarding the 
treatment of an individual who is found to lack capacity.
Section 15, Section 
75A-9-113
 is enacted to read:
75A-9-113. Disqualification to act as default surrogate.
(1)
(a)
An individual for whom a health care decision would be made may disqualify 
another individual from acting as default surrogate for the first individual.
(b)
The disqualification must be in a record signed by the first individual or 
communicated verbally or nonverbally to the individual being disqualified, another 
individual, or a responsible health care professional.
(c)
Disqualification under this subsection is effective even if made by an individual who 
lacks capacity to make an advance directive if the individual clearly communicates a 
desire that the individual being disqualified not make health care decisions for the 
individual.
(2)
An individual is disqualified from acting as a default surrogate for an individual who 
lacks capacity to make health care decisions if:
(a)
a court finds that the potential default surrogate poses a danger to the individual's 
well-being, even if the court does not issue a protective order against the potential 
surrogate;
(b)
the potential default surrogate is an owner, operator, employee, or contractor of a 
nursing home or assisted living facility in which the individual is residing or 
receiving care unless the owner, operator, employee, or contractor is a family 
member of the individual, the cohabitant of the individual, or a descendant of the 
cohabitant; or
(c)
the potential default surrogate refuses to provide a timely declaration under 
Subsection 
75A-9-111(3)
.
Section 16, Section 
75A-9-114
 is enacted to read:
75A-9-114. Revocation.
(1)
An individual may revoke the appointment of an agent, the designation of a default 
surrogate, or a health care instruction in whole or in part, unless:
(a)
a court finds the individual lacks capacity to do so; or
(b)
the individual is found under Subsection 
75A-9-103(2)
 to lack capacity to do so and, 
if the individual objects to the finding, the finding is confirmed under Subsection 
75A-9-104(4)(d)
.
(2)
Revocation under Subsection (1) may be by any act of the individual that clearly 
indicates that the individual intends to revoke the appointment, designation, or 
instruction, including an oral statement to a health care professional.
(3)
Except as provided in Section 
75A-9-109
, an advance health care directive of an 
individual that conflicts with another advance health care directive of the individual 
revokes the earlier directive to the extent of the conflict.
(4)
Unless otherwise provided in an individual's advance health care directive appointing an 
agent, the appointment of a spouse of an individual as agent for the individual is revoked 
if:
(a)
a petition for annulment, divorce, dissolution of marriage, legal separation, or 
termination has been filed and not dismissed or withdrawn;
(b)
a decree of annulment, divorce, dissolution of marriage, legal separation, or 
termination has been issued;
(c)
the individual and the spouse have agreed in a record to a legal separation; or
(d)
the spouse has willfully deserted the individual for more than one year.
Section 17, Section 
75A-9-115
 is enacted to read:
75A-9-115. Validity of advance health care directive -- Conflict with other law.
(1)
An advance health care directive created outside this state is valid if it complies with:
(a)
the law of the state specified in the directive or, if a state is not specified, the state in 
which the individual created the directive; or
(b)
this chapter.
(2)
A person may assume without inquiry that an advance health care directive is genuine, 
valid, and still in effect, and may implement and rely on it, unless the person has good 
cause to believe the directive is invalid or has been revoked.
(3)
An advance health care directive, revocation of a directive, or a signature on a directive 
or revocation may not be denied legal effect or enforceability solely because it is in 
electronic form.
(4)
Evidence relating to an advance health care directive, revocation of a directive, or a 
signature on a directive or revocation may not be excluded in a proceeding solely 
because the evidence is in electronic form.
(5)
This chapter does not affect the validity of an electronic record or signature that is valid 
under Title 46, Chapter 4, Uniform Electronic Transactions Act. 
(6)
If this chapter conflicts with other law of this state relating to the creation, execution, 
implementation, or revocation of an advance health care directive, this chapter prevails.
Section 18, Section 
75A-9-116
 is enacted to read:
75A-9-116. Duties of agent or default surrogate.
(1)
An agent or default surrogate has a fiduciary duty to the individual for whom the agent 
or default surrogate is acting when exercising or purporting to exercise a power under 
Section 
75A-9-117
.
(2)
An agent or default surrogate shall make a health care decision in accordance with the 
direction of the individual in an advance health care directive and other goals, 
preferences, and wishes of the individual to the extent known or reasonably 
ascertainable by the agent or default surrogate.
(3)
If there is not a direction in an advance health care directive and the goals, preferences, 
and wishes of the individual regarding a health care decision are not known or 
reasonably ascertainable by the agent or default surrogate, the agent or default surrogate 
shall make the decision in accordance with the agent's or default surrogate's 
determination of the individual's best interest.
(4)
In determining the individual's best interest under Subsection (3), the agent or default 
surrogate shall:
(a)
give primary consideration to the individual's contemporaneous communications, 
including verbal and nonverbal expressions;
(b)
consider the individual's values to the extent known or reasonably ascertainable by 
the agent or default surrogate; and
(c)
consider the risks and benefits of the potential health care decision.
(5)
As soon as reasonably feasible, an agent or default surrogate who is informed of a 
revocation of an advance health care directive or disqualification of the agent or default 
surrogate shall communicate the revocation or disqualification to a responsible health 
care professional.
Section 19, Section 
75A-9-117
 is enacted to read:
75A-9-117. Powers of agent and default surrogate.
(1)
(a)
Except as provided in Subsection (3), the power of an agent or default surrogate 
commences when the individual is found under Subsection 
75A-9-103(2)
 or by a 
court to lack capacity to make a health care decision.
(b)
The power ceases if the individual later is found to have capacity to make a health 
care decision, or the individual objects under Subsection 
75A-9-104(3)
 to the finding 
of lack of capacity under Subsection 
75A-9-103(2)
.
(c)
The power resumes if:
(i)
the power ceased because the individual objected under Subsection 
75A-9-104(3)
; 
and
(ii)
the finding of lack of capacity is confirmed under Subsection 
75A-9-104(4)(d)
 or 
a court finds that the individual lacks capacity to make a health care decision.
(2)
An agent or default surrogate may request, receive, examine, copy, and consent to the 
disclosure of medical and other health care information about the individual if the 
individual would have the right to request, receive, examine, copy, or consent to the 
disclosure of the information.
(3)
A power of attorney for health care may provide that the power of an agent under 
Subsection (1) commences on appointment.
(4)
(a)
If no other person is authorized to do so, an agent or default surrogate may apply 
for public or private health insurance and benefits on behalf of the individual.
(b)
An agent or default surrogate who may apply for insurance and benefits does not, 
solely by reason of the power, have a duty to apply for the insurance or benefits.
(5)
An agent or default surrogate may not consent to voluntary admission of the individual 
to a facility for mental health treatment unless:
(a)
voluntary admission is specifically authorized by the individual in an advance health 
care directive in a record; and
(b)
the admission is for no more than the maximum of the number of days specified in 
the directive.
(6)
Except as provided in Subsection (7), an agent or default surrogate may not consent to 
placement of the individual in a nursing home if the placement is intended to be for 
more than 100 days if:
(a)
an alternative living arrangement is reasonably feasible;
(b)
the individual objects to the placement; or
(c)
the individual is not terminally ill.
(7)
If specifically authorized by the individual in an advance health care directive in a 
record, an agent or default surrogate may consent to placement of the individual in a 
nursing home for more than 100 days even if:
(a)
an alternative living arrangement is reasonably feasible;
(b)
the individual objects to the placement; and
(c)
the individual is not terminally ill.
Section 20, Section 
75A-9-118
 is enacted to read:
75A-9-118. Limitations on powers.
(1)
If an individual has a long-term disability requiring routine treatment by artificial 
nutrition, hydration, or mechanical ventilation and a history of using the treatment 
without objection, an agent or default surrogate may not consent to withhold or 
withdraw the treatment unless:
(a)
the treatment is not necessary to sustain the individual's life or maintain the 
individual's well-being;
(b)
the individual has expressly authorized the withholding or withdrawal in a health 
care instruction that has not been revoked; or
(c)
the individual has experienced a major reduction in health or functional ability from 
which the individual is not expected to recover, even with other appropriate 
treatment, and the individual has not:
(i)
given a direction inconsistent with withholding or withdrawal; or
(ii)
communicated by verbal or nonverbal expression a desire for artificial nutrition, 
hydration, or mechanical ventilation.
(2)
A default surrogate may not make a health care decision if, under other law of this state, 
the decision:
(a)
may not be made by a guardian; or
(b)
may be made by a guardian only if the court appointing the guardian specifically 
authorizes the guardian to make the decision.
Section 21, Section 
75A-9-119
 is enacted to read:
75A-9-119. Co-agents -- Alternate agent.
(1)
(a)
An individual in a power of attorney for health care may appoint multiple 
individuals as co-agents.
(b)
Unless the power of attorney provides otherwise, each co-agent may exercise 
independent authority.
(2)
An individual in a power of attorney for health care may appoint one or more 
individuals to act as alternate agents if a predecessor agent resigns, dies, becomes 
disqualified, is not reasonably available, or otherwise is unwilling or unable to act as 
agent.
(3)
Unless the power of attorney provides otherwise, an alternate agent has the same 
authority as the original agent:
(a)
at any time the original agent is not reasonably available or is otherwise unwilling or 
unable to act, for the duration of the unavailability, unwillingness, or inability to act; 
or
(b)
if the original agent and all other predecessor agents have resigned or died or are 
disqualified from acting as agent.
Section 22, Section 
75A-9-120
 is enacted to read:
75A-9-120. Duties of health care professional, responsible health care 
professional, and health care institution.
(1)
A responsible health care professional who is aware that an individual has been found to 
lack capacity to make a decision shall make a reasonable effort to determine if the 
individual has a surrogate.
(2)
If possible before implementing a health care decision made by a surrogate, a 
responsible health care professional as soon as reasonably feasible shall communicate to 
the individual the decision made and the identity of the surrogate.
(3)
A responsible health care professional who makes or is informed of a finding that an 
individual lacks capacity to make a health care decision or no longer lacks capacity, or 
that other circumstances exist that affect a health care instruction or the authority of a 
surrogate, as soon as reasonably feasible, shall:
(a)
document the finding or circumstance in the individual's medical record; and
(b)
if possible, communicate to the individual and the individual's surrogate the finding 
or circumstance and that the individual may object under Subsection 
75A-9-104(3)
 to 
the finding under Subsection 
75A-9-103(2)
.
(4)
A responsible health care professional who is informed that an individual has created or 
revoked an advance health care directive, or that a surrogate for an individual has been 
appointed, designated, or disqualified, shall:
(a)
document the information as soon as reasonably feasible in the individual's medical 
record; and
(b)
if evidence of the directive, revocation, appointment, designation, or disqualification 
is in a record, request a copy and, on receipt, cause the copy to be included in the 
individual's medical record.
(5)
Except as provided in Subsections (6) and (7), a health care professional or health care 
institution providing health care to an individual shall comply with:
(a)
a health care instruction given by the individual regarding the individual's health care;
(b)
a reasonable interpretation by the individual's surrogate of an instruction given by the 
individual; and
(c)
a health care decision for the individual made by the individual's surrogate in 
accordance with Sections 
75A-9-116
 and 
75A-9-117
 to the same extent as if the 
decision had been made by the individual at a time when the individual had capacity.
(6)
A health care professional or a health care institution may refuse to provide health care 
consistent with a health care instruction or health care decision if:
(a)
the instruction or decision is contrary to a policy of the health care institution 
providing care to the individual that is based expressly on reasons of conscience and 
the policy was timely communicated to the individual or to the individual's surrogate;
(b)
the care would require health care that is not available to the professional or 
institution; or
(c)
compliance with the instruction or decision would:
(i)
require the professional to provide care that is contrary to the professional's 
religious belief or moral conviction if other law permits the professional to refuse 
to provide care for that reason;
(ii)
require the professional or institution to provide care that is contrary to generally 
accepted health care standards applicable to the professional or institution; or
(iii)
violate a court order or other law.
(7)
A health care professional or health care institution that refuses to provide care under 
Subsection (6) shall:
(a)
as soon as reasonably feasible, inform the individual, if possible, and the individual's 
surrogate of the refusal;
(b)
immediately make a reasonable effort to transfer the individual to another health care 
professional or health care institution that is willing to comply with the instruction or 
decision; and
(c)
either:
(i)
if care is refused under Subsection (6)(a) or (b), provide life-sustaining care and 
care needed to keep or make the individual comfortable, consistent with accepted 
medical standards to the extent feasible, until a transfer is made; or
(ii)
if care is refused under Subsection (6)(c), provide life-sustaining care and care 
needed to keep or make the individual comfortable, consistent with accepted 
medical standards, until a transfer is made or, if the professional or institution 
reasonably believes that a transfer cannot be made, for at least 10 days after the 
refusal.
Section 23, Section 
75A-9-121
 is enacted to read:
75A-9-121. Decision by guardian.
(1)
A guardian may refuse to comply with or revoke the individual's advance health care 
directive only if the court appointing the guardian expressly orders the noncompliance or 
revocation.
(2)
Unless a court orders otherwise, a health care decision made by an agent appointed by 
an individual subject to guardianship prevails over a decision of the guardian appointed 
for the individual.
Section 24, Section 
75A-9-122
 is enacted to read:
75A-9-122. Immunity.
(1)
A health care professional or health care institution acting in good faith is not subject to 
civil or criminal liability or to discipline for unprofessional conduct for:
(a)
complying with a health care decision made for an individual by another person if 
compliance is based on a reasonable belief that the person has authority to make the 
decision, including a decision to withhold or withdraw health care;
(b)
refusing to comply with a health care decision made for an individual by another 
person if the refusal is based on a reasonable belief that the person lacked authority or 
capacity to make the decision;
(c)
complying with an advance health care directive based on a reasonable belief that the 
directive is valid;
(d)
refusing to comply with an advance health care directive based on a reasonable belief 
that the directive is not valid, including a reasonable belief that the directive was not 
made by the individual or, after its creation, was substantively altered by a person 
other than the individual who created it; or
(e)
determining that an individual who otherwise might be authorized to act as an agent 
or default surrogate is not reasonably available.
(2)
An agent, default surrogate, or individual with a reasonable belief that the individual is 
an agent or a default surrogate is not subject to civil or criminal liability or to discipline 
for unprofessional conduct for a health care decision made in a good faith effort to 
comply with Section 
75A-9-116
.
Section 25, Section 
75A-9-123
 is enacted to read:
75A-9-123. Prohibited conduct -- Damages.
(1)
A person may not:
(a)
intentionally falsify, in whole or in part, an advance health care directive;
(b)
for the purpose of frustrating the intent of the individual who created an advance 
health care directive or with knowledge that doing so is likely to frustrate the intent:
(i)
intentionally conceal, deface, obliterate, or delete the directive or a revocation of 
the directive without consent of the individual who created or revoked the 
directive; or
(ii)
intentionally withhold knowledge of the existence or revocation of the directive 
from a responsible health care professional or health care institution providing 
health care to the individual who created or revoked the directive;
(c)
coerce or fraudulently induce an individual to create, revoke, or refrain from creating 
or revoking an advance health care directive or a part of a directive; or
(d)
require or prohibit the creation or revocation of an advance health care directive as a 
condition for providing health care.
(2)
An individual who is the subject of conduct prohibited under Subsection (1), or the 
individual's estate, has a cause of action against a person that violates Subsection (1) for 
statutory damages of $25,000 or actual damages resulting from the violation, whichever 
is greater.
(3)
Subject to Subsection (4), an individual who makes a health care instruction, or the 
individual's estate, has a cause of action against a health care professional or health care 
institution that intentionally violates Section 
75A-9-120
 for statutory damages of 
$50,000 or actual damages resulting from the violation, whichever is greater.
(4)
A health care professional who is an emergency medical services provider is not liable 
under Subsection (3) for a violation of Subsection 
75A-9-120(5)
 if:
(a)
the violation occurs in the course of providing care to an individual experiencing a 
health condition for which the emergency medical services provider reasonably 
believes the care was appropriate to avoid imminent loss of life or serious harm to the 
individual;
(b)
the failure to comply is consistent with accepted standards of the profession of the 
emergency medical services provider; and
(c)
the provision of care does not begin in a health care institution in which the 
individual resides or was receiving care.
(5)
In an action under this section, a prevailing plaintiff may recover reasonable attorney 
fees, court costs, and other reasonable litigation expenses.
(6)
A cause of action or remedy under this section is in addition to any cause of action or 
remedy under other law.
Section 26, Section 
75A-9-124
 is enacted to read:
75A-9-124. Effect of copy -- Certified physical copy.
(1)
A physical or electronic copy of an advance health care directive, revocation of an 
advance health care directive, or appointment, designation, or disqualification of a 
surrogate has the same effect as the original.
(2)
An individual may create a certified physical copy of an advance health care directive or 
revocation of an advance health care directive that is in electronic form by affirming 
under penalty of perjury that the physical copy is a complete and accurate copy of the 
directive or revocation.
Section 27, Section 
75A-9-125
 is enacted to read:
75A-9-125. Judicial relief.
(1)
On petition of an individual, the individual's surrogate, a health care professional or 
health care institution providing health care to the individual, or a person interested in 
the welfare of the individual, the court may:
(a)
enjoin implementation of a health care decision made by an agent or default 
surrogate on behalf of the individual, on a finding that the decision is inconsistent 
with Section 
75A-9-116
 or 
75A-9-117
;
(b)
enjoin an agent from making a health care decision for the individual, on a finding 
that the individual's appointment of the agent has been revoked or the agent:
(i)
is disqualified under Subsection 
75A-9-107(2)
;
(ii)
is unwilling or unable to comply with Section 
75A-9-116
; or
(iii)
poses a danger to the individual's well-being;
(c)
enjoin another individual from acting as a default surrogate, on a finding that the 
other individual:
(i)
acting as a default surrogate did not comply with Section 
75A-9-111
;
(ii)
is disqualified under Section 
75A-9-113
;
(iii)
is unwilling or unable to comply with Section 
75A-9-116
;
(iv)
poses a danger to the first individual's well-being; or
(d)
order implementation of a health care decision made:
(i)
by and for the individual; or
(ii)
by an agent or default surrogate who is acting in compliance with the powers and 
duties of the agent or default surrogate.
(2)
In this chapter, advocacy for the withholding or withdrawal of health care or mental 
health care from an individual is not itself evidence that an agent or default surrogate, or 
a potential agent or default surrogate, poses a danger to the individual's well-being.
(3)
A proceeding under this chapter is governed by the Utah Rules of Civil Procedure and 
shall be expedited by the court.
Section 28, Section 
75A-9-126
 is enacted to read:
75A-9-126. Construction.
(1)
This chapter does not authorize mercy killing, assisted suicide, or euthanasia.
(2)
This chapter does not affect other law of this state governing treatment for mental 
illness of an individual involuntarily committed under Section 
26B-5-332
.
(3)
Death of an individual caused by withholding or withdrawing health care in accordance 
with this chapter does not constitute a suicide or homicide or legally impair or invalidate 
a policy of insurance or an annuity providing a death benefit, notwithstanding any term 
of the policy or annuity.
(4)
This chapter does not create a presumption concerning the intention of an individual 
who has not created an advance health care directive.
(5)
An advance health care directive created before, on, or after January 1, 2026, shall be 
interpreted in accordance with law of this state, excluding the state's choice-of-law rules, 
at the time the directive is implemented.
Section 29, Section 
75A-9-127
 is enacted to read:
75A-9-127. Uniformity of application and construction.
In applying and construing this uniform act, a court shall consider the promotion of 
uniformity of the law among jurisdictions that enact it.
Section 30, Section 
75A-9-128
 is enacted to read:
75A-9-128. Saving provision.
(1)
An advance health care directive created before January 1, 2026, is valid if it complies 
with this chapter or complied at the time of creation with the law of the state in which it 
was created.
(2)
This chapter does not affect the validity or effect of an act done before January 1, 2026.
(3)
An individual who assumed authority to act as default surrogate before January 1, 2026, 
may continue to act as default surrogate until the individual for whom the default 
surrogate is acting has capacity or the default surrogate is disqualified, whichever occurs 
first.
Section 31, Section 
75A-9-129
 is enacted to read:
75A-9-129. Transitional provision.
This chapter applies to an advance health care directive created before, on, or after 
January 1, 2026.
Section 32, 
Repealer.
Intent statement.
Effect of chapter.
Provisions cumulative with existing law.
Severability.
Judicial relief.
Capacity to make health care decisions -- Presumption -- 
Overcoming presumption.
Effect of current health care preferences -- Health care decision 
making.
Default surrogates.
Surrogate decision making -- Scope of authority.
Health care decisions by guardian.
Priority of decision makers.
Notification to health care provider -- Obligations of health care 
providers -- Liability.
Personal representative status.
Advance health care directive -- Appointment of agent -- Powers of 
agent.
Capacity to complete an advance health care directive.
Optional form for advance health care directive.
Presumption of validity of advance health care directive.
Advance health care directive effect on insurance policies.
Advance health care directive effect during pregnancy.
Revocation of advance health care directive.
Illegal destruction or falsification of advance health care directive.
Reciprocity of advance health care directive -- Application of former 
provisions of law.
Section 33. 
Effective Date.
This bill takes effect on 
January 1, 2026
.
2-13-25 9:13 AM