A. If an adult patient is unable to make or communicate health care treatment decisions, a health care provider shall make a reasonable effort to locate and shall follow a health care directive. A health care provider shall also make a reasonable effort to consult with a surrogate. If the patient has a health care power of attorney that meets the requirements of section 36-3221, the patient’s designated agent shall act as the patient’s surrogate. However, if the court appoints a guardian for the express purpose of making health care treatment decisions, that guardian shall act as the patient’s surrogate. If neither of these situations applies, the health care provider shall make reasonable efforts to contact the following individual or individuals in the indicated order of priority, who are available and willing to serve as the surrogate, who then have the authority to make health care decisions for the patient and who shall follow the patient’s wishes if they are known:

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Terms Used In Arizona Laws 36-3231

  • Adult: means a person who has attained eighteen years of age. See Arizona Laws 1-215
  • Agent: means an adult who has the authority to make health care treatment decisions for another person, referred to as the principal, pursuant to a health care power of attorney. See Arizona Laws 36-3201
  • Attending physician: means a physician who has the primary responsibility for a principal's health care. See Arizona Laws 36-3201
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Health care directive: means a document drafted in substantial compliance with this chapter, including a mental health care power of attorney, to deal with a person's future health care decisions. See Arizona Laws 36-3201
  • Health care provider: means a natural person who is licensed under Title 32, Chapter 11, 13, 15, 17 or 25, a hospice as defined in section 36-401 that is licensed under chapter 4 of this title or an organization that is licensed under this title, that renders health care designed to prevent, diagnose or treat illness or injury and that employs persons licensed under Title 32, Chapter 11, 13, 15, 17 or 25. See Arizona Laws 36-3201
  • Inpatient psychiatric facility: means a hospital that contains an organized psychiatric services unit or a special hospital that is licensed to provide psychiatric services. See Arizona Laws 36-3201
  • Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
  • Physician: means a doctor of medicine licensed pursuant to title 32, chapter 13 or doctor of osteopathic medicine licensed pursuant to Title 32, Chapter 17. See Arizona Laws 36-3201
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Surrogate: means a person authorized to make health care decisions for a patient by a power of attorney, a court order or the provisions of section 36-3231. See Arizona Laws 36-3201

1. The patient’s spouse, unless the patient and spouse are legally separated.

2. An adult child of the patient. If the patient has more than one adult child, the health care provider shall seek the consent of a majority of the adult children who are reasonably available for consultation.

3. A parent of the patient.

4. If the patient is unmarried, the patient’s domestic partner.

5. A brother or sister of the patient.

6. A close friend of the patient. For the purposes of this paragraph, "close friend" means an adult who has exhibited special care and concern for the patient, who is familiar with the patient’s health care views and desires and who is willing and able to become involved in the patient’s health care and to act in the patient’s best interest.

B. If the health care provider cannot locate any of the people listed in subsection A of this section, the patient’s attending physician may make health care treatment decisions for the patient after the physician consults with and obtains the recommendations of an institutional ethics committee. If this is not possible, the physician may make these decisions after consulting with a second physician who concurs with the physician’s decision. For the purposes of this subsection, "institutional ethics committee" means a standing committee of a licensed health care institution appointed or elected to render advice concerning ethical issues involving medical treatment.

C. A person who makes a good faith medical decision pursuant to this section is immune from liability to the same extent and under the same conditions as prescribed in section 36-3205.

D. A surrogate may make decisions about mental health care treatment on behalf of a patient if the patient is found incapable. However, a surrogate who is not the patient’s agent or guardian shall not make decisions to admit the patient to an inpatient psychiatric facility licensed by the department of health services, except as provided in subsection E of this section or Section 14-5312.01, 14-5312.02 or 36-3281.

E. If the admitting officer for a mental health care provider has reasonable cause to believe after examination that the patient is incapable as defined in section 36-3281 and is likely to suffer serious physical harm or serious illness or to inflict serious physical harm on another person without immediate hospitalization, the patient may be admitted for inpatient treatment in an inpatient psychiatric facility based on informed consent given by any surrogate identified in subsection A of this section. The patient shall be discharged if a petition for court ordered evaluation or for temporary guardianship requesting authority for the guardian to consent to admission to an inpatient psychiatric facility has not been filed within forty-eight hours of admission or on the following court day if the forty-eight hours expires on a weekend or holiday. The discharge requirement prescribed in this section does not apply if the patient has given informed consent to voluntary treatment or if a mental health care provider is prohibited from discharging the patient under federal law.