The Most Recent Directive Wins
Over the course of a lifetime, it is not unusual for someone to sign more than one health care directive. Preferences change. Medical conditions evolve. A directive signed at age 55 might not reflect the same choices at 75. Arizona law handles this by applying a simple rule: the most recent directive is presumed to represent your current wishes.
If there are conflicts among the provisions of valid health care directives, the most recent directive is deemed to represent the wishes of the patient.
A.R.S. § 36-3209(A)This is one reason keeping your estate planning documents up to date matters. If your old directive says one thing and your new one says something different, the new one controls. But if the old directive was never formally revoked, it could create confusion for family members and medical providers who may not know which version is current.
Your Wishes Override a Doctor's Order
Conflicts do not always involve two directives. Sometimes the conflict is between what you documented in your directive and what a doctor has ordered. Arizona law addresses this clearly.
If there is a conflict between a provision of a valid health care directive, the decision of a patient's agent pursuant to a valid health care power of attorney or the decision of a surrogate decision maker pursuant to section 36-3231 and a health care provider's order, including an order regarding life-sustaining treatment or a similar document, the health care directive, the decision of the patient's agent or the decision of the surrogate decision maker is presumed to represent the decision of the patient.
A.R.S. § 36-3209(B)In practical terms, your written wishes and the decisions made by your agent or surrogate carry more weight than a standing medical order. This gives families confidence that the instructions they helped put in place will be followed, even if a provider's default protocol would lead to a different outcome.
