Living Wills vs. Health Care Directives in Utah
As the new year begins, moments of reflection have a way of catching us off guard, even in unexpected places. When HBO’s new show The Pitt premiered, I tuned in partly out of loyalty to my alma mater, the University of Pittsburgh, and partly for the nostalgia for a city I grew to love. Although the familiar skyline caught my attention, what stood out was a storyline rooted in a very real dilemma about end-of-life medical decisions.
In the episode, a patient with Alzheimer’s disease arrives at the ER in respiratory distress. His advance directive rejects mechanical ventilation, yet his adult children, who both hold durable power of attorney, disagree. His son wants to follow the directive, but his daughter urges intubation. The physician notes that intubation would cause suffering and undermine the patient’s autonomy, but could ease the family’s emotional burden. Ultimately, the children override their father’s wishes. The episode offers no clear resolution. Instead, it leaves viewers with a question that is especially worth considering at the start of a new year:
Can a surrogate decision-maker’s authority outweigh the patient’s clearly stated preferences?
As with most ethical dilemmas, the “right” choice is rarely clear, but such conflicts can often be avoided through advance planning, specifically by understanding the difference between a living will and a health care directive. In Utah, the Uniform Health Care Decisions Act merges a living will and medical power of attorney into one standardized document. This was designed to reduce ambiguity and minimize disputes between a patient’s instructions and a surrogate’s authority.
Why These Conversations Matter
In real ERs in Utah, families are often forced to make irreversible decisions under crushing time pressure and emotional strain. And while medical care is deeply personal, it’s often unspoken until crisis strikes. Questions such as:
- Would I want to be on life support with no chance of recovery?
- If in a permanent vegetative state, would I want to be resuscitated?
- Who would I trust to make those decisions if I couldn’t?
- Would that person know my beliefs, values, and medical preferences?
These aren’t easy conversations, but from both a legal and a practical standpoint, they’re essential. In Utah, part of that conversation involves understanding the difference between a living will, an advance directive, and a health care directive.
What is a Living Will in Utah?
Despite its name, a living will has nothing to do with your property, your bank account, or who inherits your record collection. A living will is a written statement outlining your wishes for medical treatment if you are unable to communicate and your condition is terminal or irreversible.
This is where you specify whether you’d want life-sustaining treatments such as:
- CPR
- Ventilators
- Feeding tubes
- Pain management approaches
- Organ donation preferences
You can think of it as your “treatment preferences” document with clear instructions for specific scenarios.
However, a living will, standing alone, doesn’t appoint anyone to speak for you. If a situation arises that isn’t clearly covered in your written instructions, there’s no designated voice to clarify. That’s why, in Utah, it’s rarely used by itself anymore and rolled into a broader Utah health care directive.
What is an Advance Directive?
An advance directive is an umbrella term for legal documents that:
- State your health care preferences
- Often appoint someone to make decisions for you.
A living will is one part of an advance directive, but other pieces might include:
- A medical power of attorney
- Mental health care advance directive.
The idea is to combine your written wishes with a trusted person’s authority to act on them, filling the gaps where the paperwork alone might fall short.
The Utah Uniform Health Care Decisions Act Explained
In Utah, the law has merged the living will and the medical power of attorney into one standardized document: the Utah Uniform Health Care Decisions Act.
This single form covers two critical areas:
- Treatment Preferences: Just like a living will, you can spell out the kinds of care you want or don’t want, particularly in end-of-life scenarios.
- Health Care Agent: You can legally appoint someone you trust (often a spouse, adult child, or close friend) to make medical decisions for you if you cannot.
The advantage is clear: your wishes are documented, and you’ve chosen the person to carry them out. If you only have a living will, you risk leaving unanswered questions. If you only have a power of attorney, you risk burdening your decision-maker with no guidance. Together, the directive gives clarity and authority.
Living Will vs. Health Care Directive in Utah: Key Differences
Feature |
Living Will (Before 2008) |
Utah Advance Health Care Directive (After 2008) |
|---|---|---|
Treatment Choices |
Only for end-of-life care (life support, feeding tubes) | Covers many choices, like end-of-life care, pain relief, organ donation |
Decision Maker |
No, you can’t name someone to decide for you | Yes, you can name someone to decide for you if you can’t |
When It Applies |
Only if you are dying or permanently unconscious | Anytime you can’t make your own medical decisions |
Form Used |
Old “Living Will” form (not valid anymore) | Utah Advance Health Care Directive form (current official form) |
Legal Status |
Not valid since 2008 | Legally accepted in Utah |
Flexibility |
Very limited choices | Can be customized to your wishes |
Witness/Notary |
May have needed a witness or notary | Needs either one witness or notarization |
Why Every Utah Adult Should Have a Health Care Directive
Too many people treat these documents like bureaucratic paperwork when they’re legal shields for your autonomy and emotional lifelines for your loved ones. Without a directive, your care could be decided by:
- The court
- Default state laws
Even with the best intentions, family members often disagree, especially in stressful emergencies.
In that Pitt episode, the son knew his father’s choice. But in the heat of the moment, he deferred to his sister. That’s how documented wishes get overridden. Utah’s unified directive is designed to minimize those moments of doubt and prevent painful second-guessing.
What’s in Utah’s Standard Form
The Utah Uniform Health Care Decisions Act includes:
- Your medical treatment preferences, including end-of-life care
- The option to appoint a health care surrogate or agent
- Space to express personal values, religious beliefs, or other instructions
- Signature and witnessing requirements for legal validity
It’s straightforward but powerful when it’s completed correctly.
The Human Side of Health Care Planning
Even a brief look behind the curtain of health care reveals that the human side is just as powerful as the clinical one. Stress, fear, and uncertainty can drive decisions in ways no one expects, and a clear, legally binding plan can make those moments far less daunting.
In cities with world-class medical resources, from Pittsburgh to Salt Lake City, these conversations about care often don’t happen until it’s too late. Once emotions take over, even the most loving families can find themselves in conflict.
The Takeaway
Every directive is more than a form. Rather, it’s a promise to yourself and to your loved ones. It’s a way to ensure that if you can’t speak for yourself, your voice is still heard.
None of us knows when a medical crisis will strike, but you can decide in advance what care you want and who should make decisions for you. It’s not glamorous, and yes, it can feel a little morbid. But as my fellow millennials would say, it’s peak “adulting,” and one of the most important steps you can take.
Pro Tip for Utah Residents: Download the official Utah Advance Health Care Directive form from the Utah Department of Health and review it with your attorney.
Ready to Make Your Wishes Known?
At Christensen & Jensen, we help clients create Utah healthcare directives that reflect their personal values and comply with Utah law. Whether you’re completing one for the first time or updating an old version, we can guide you through the process so you can move forward with peace of mind. Contact us today to get started.
