The Most Recent Directive Wins
Over 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 represents 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 an old directive says one thing and a new one says something different, the new one controls. But if the old directive was never formally revoked, it could create confusion. Family members and medical providers may not know which version is current. Keeping a clear medical record of the most recent directive helps avoid this problem.
Your Wishes Override Physician Orders
Conflicts do not always involve two directives. Sometimes the conflict is between what you documented in your directive and what a doctor has ordered. This type of advance directive conflict is addressed clearly by Arizona law.
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 standing physician orders. This gives families confidence that the instructions they helped put in place will be followed. Even if a provider's default protocol for medical treatments would lead to a different outcome, the patient's directive or the decision of the agent under a durable power of attorney takes priority.
Keeping Documents Current
Many families find it helpful to review their life care and healthcare planning documents every few years. Updating a directive after a major health change or life event ensures the most recent document truly reflects current preferences. This reduces the chance of a conflict and makes it easier for providers and family to follow the right instructions.