Utah Advance Directive: Requirements, Agents, and Signing Rules

A Utah advance directive is a single statutory document that names someone to make your medical decisions if you cannot and records your end-of-life treatment preferences in writing. To create one, you must be at least 18, have decision-making capacity, complete Utah’s statutory form (Part I appoints an agent; Part II records your end-of-life choice), and sign it in front of one qualified adult witness. The form, authorized under Title 75A, Chapter 3 of the Utah Code, replaces any older living will or medical power of attorney you previously signed.¹

Who Can Create One

Utah presumes every adult has the capacity to create or revoke an advance health care directive.² The age of majority is 18.³ If you are 18 or older and can understand the choices in front of you, you qualify. No doctor’s note or mental evaluation is needed, and a relative’s disagreement is not enough to invalidate the document; capacity can only be overcome through a formal determination.

Naming Your Health Care Agent

Part I of the form designates your health care agent, the person who speaks for you when you cannot speak for yourself.⁴ You list the agent’s name and contact information, and there is a space for an alternate who steps in if your first choice cannot serve.

By default, the agent’s authority activates only after a physician or other authorized provider determines you lack capacity to make your own health care decisions. While you can still communicate, you keep full control. Once activated, your agent can consent to or refuse treatment, hire and fire providers, authorize facility transfers, access your medical records, and request consultations.

You can narrow or expand this authority on the form. Most people grant broad authority, but if you feel strongly about a particular treatment, you can carve it out and address it through written instructions in Part II rather than leaving it to your agent’s judgment. Pick someone you trust completely, and talk through your values with them before a crisis forces guesswork.

Choosing an End-of-Life Option

Part II of the form offers four numbered choices for how your medical team should handle end-of-life care.⁴ You pick one.

Option 1 lets your agent decide. You trust your agent to make end-of-life decisions based on prior conversations with you.
Option 2 directs the team to prolong life. Regardless of your condition or prognosis, you want life extended as long as possible within accepted medical standards.
Option 3 directs the team not to prolong life under conditions you specify. You can refuse life-sustaining measures such as tube feeding, antibiotics used solely to prolong life, CPR, or dialysis if you have a progressive terminal illness or are close to death with little chance of recovery. You initial the specific triggering conditions.
Option 4 states no preference and leaves end-of-life decisions to your agent or, if none, to Utah’s default surrogate process.

Option 3 takes the most thought because the triggering conditions have to be initialed individually. Read each one carefully rather than assuming it blankets every terminal scenario.

Organ Donation and Written Instructions

Part I also includes an organ donation section where you can consent to donation or decline. If you say nothing, your agent can consent on your behalf unless you specifically prohibit it.

The form provides blank space for additional written instructions. This is where religious convictions, cultural practices, or specific treatment preferences belong. If your faith prohibits blood transfusions or you want comfort-focused care in defined circumstances, write it in. Instructions here carry the same legal weight as the numbered options. Concrete guidance is more useful than a line like “I want to be comfortable.”

Signing and Witness Requirements

You sign the directive in the presence of one disinterested adult witness. Utah disqualifies a long list of people from serving as that witness. The witness cannot be any of the following:⁵

Your designated agent or alternate agent
Anyone who signed the directive on your behalf
A relative by blood or marriage
Anyone entitled to a portion of your estate under intestacy or a will
A beneficiary of your life insurance, trust, retirement plan, pay-on-death account, or transfer-on-death deed
Anyone who benefits financially from your death
A person directly financially responsible for your medical care
A health care provider currently treating you, or an administrator at your care facility

The list is stricter than many people expect, and it rules out most close family members along with anyone who has a financial tie to your estate or care. A neighbor, coworker, or friend with no such connection is usually the safest choice. Notarization is not required, though some people notarize for easier recognition by out-of-state providers. The statute allows an oral directive, but a properly witnessed written form is far more practical and harder to dispute.

Changing or Revoking Your Directive

You can revoke or change the directive at any time while you still have capacity. The statutory form lists four methods:⁴

Destroy or deface the document. Write “void” across the form, or burn, tear, or otherwise destroy it. You can direct another person to do this for you.
Sign a written revocation. A separate signed statement revoking the directive, signed by you or by someone you direct.
Make an oral statement in front of a qualifying witness. The witness must be at least 18, cannot be your agent in a replacement directive, and cannot be your default surrogate if the directive is revoked. The witness signs and dates a written confirmation of what you said.
Sign a new directive. A newer directive automatically replaces an older one, and the form itself revokes any previously completed living will or health care power of attorney.

One automatic revocation catches people off guard. If you named your spouse as agent and later file for divorce, legal separation, or annulment, that appointment is revoked by operation of law. Going through a separation is a cue to sign a fresh directive naming a different agent.

Getting Copies Where They Need to Be

A directive nobody can find during a crisis does nothing. Give a copy to your primary care physician for scanning into your electronic health record. Give one to the hospital most likely to treat you. Your agent needs a copy to prove authority to hospital staff, and your alternate should have one too. Keep a copy accessible at home and tell close family where it is. If anything changes, replace all the old copies.

What Happens If You Don’t Have One

If you lose capacity without a directive, Utah assigns a default surrogate from a statutory priority list.⁶ At the top sits any adult you had previously named informally as the person you wanted making your decisions. Below that come your spouse (unless a divorce or separation is pending, or your spouse has deserted you for more than a year), then your adult child or parent, then your cohabitant, then your adult sibling, and so on through more distant relatives, long-term helpers, stepchildren you raised, and finally an adult who has shown special concern and knows your values. If no one qualifies, a physician can be designated through a statutory process.

The surrogate system works, but it is slower and less certain than a directive. When two relatives at the same level disagree, treatment can stall. A directive puts one person clearly in charge and records your preferences in writing.

The Pregnancy Limitation

Utah law contains an important limit. An advance directive instructing providers to withhold or withdraw life-sustaining treatment has no force during the course of a pregnancy.⁷ If you are pregnant and lose capacity, the medical team must continue life-sustaining treatment regardless of what your Option 3 instructions say. Your agent’s appointment is not cancelled, and the agent can still make other health care decisions. The directive simply cannot authorize withdrawal of life support while you are pregnant.

What This Form Does Not Cover

Two other Utah documents sit alongside the advance directive and handle situations it does not.

An Order for Life-Sustaining Treatment (OLST, previously POLST) is a set of medical orders for people who are seriously ill or medically frail, and a health care provider must sign it. The practical difference matters in an emergency: paramedics are required to follow an OLST but cannot honor an advance directive in the field. Without an OLST, they will stabilize you and transport you to a hospital, where the advance directive takes effect once a physician evaluates you. If you have a serious illness, ask your doctor whether an OLST belongs alongside your directive.

A declaration for mental health treatment, governed by Utah Code 26B-5-315, handles psychiatric care that the standard directive does not cover.⁸ It addresses three specific treatments: psychoactive medication, convulsive therapy such as electroconvulsive therapy, and short-term admission to a mental health facility for up to 17 days. You can consent to or refuse each one in advance and appoint someone to interpret your preferences during a crisis. If you have a psychiatric condition with strong feelings about future treatment, completing both the standard directive and the mental health declaration covers both domains.

1
Utah Legislature. Utah Code 75A-3-P3 – Advance Health Care Directive for Adult
2
Utah Legislature. Utah Code 75-2a-104 – Capacity to Make Health Care Decisions
3
Utah Legislature. Utah Code 15-2-1 – Period of Minority
4
Utah Legislature. Utah Code 75A-3-303 – Optional Form for Advance Health Care Directive
5
Utah Legislature. Utah Code 75A-3-301 – Advance Health Care Directive – Appointment of Agent – Powers of Agent
6
Utah Legislature. Utah Code 75A-9-111 – Default Surrogate
7
Utah Legislature. Utah Code 75A-3-306 – Advance Health Care Directive Effect During Pregnancy
8
Utah Legislature. Utah Code 26B-5-315 – Declaration for Mental Health Treatment