Default Health-Care Surrogate Priority in Arizona

At a glance

Requirements one by one

When the default route opens

Arizona § 36-3231(A) applies when an adult cannot make or communicate a health-care treatment decision. The provider must make a reasonable effort to locate and follow a directive, and to consult a surrogate. If an effective health-care power of attorney designates an agent, that agent acts, unless a court has appointed a guardian expressly for treatment decisions.

Family and partner order

Section 36-3231(A)(1)–(5) excludes a legally separated spouse from the first class. An adult child comes next, then a parent; a domestic partner follows only when the patient is unmarried. A brother or sister comes after the partner. Each potential surrogate must be available and willing to serve.

Friend or other nonfamily person

The last personal class is a close friend under § 36-3231(A)(6). The friend must be an adult who has shown special care and concern, knows the patient's health-care views and desires, and is willing and able to take part in care and act in the patient's best interest.

Decision within one class

If several adult children exist, § 36-3231(A)(2) requires the provider to seek consent from a majority of children reasonably available for consultation. The section names no comparable sibling vote. It gives no express tie breaker when available children are evenly split.

Decisions limited or excluded

Section 36-3231(D) lets an incapable patient's surrogate decide mental-health treatment but generally reserves consent to admission to a licensed inpatient psychiatric facility to an agent or guardian. Subsection E permits an urgent admission on consent by any listed surrogate after the admitting officer's examination and specified danger finding. A court petition must be filed within forty-eight hours, or the following court day if that period ends on a weekend or holiday, to avoid the statute's discharge rule; the stated voluntary-consent and federal-law exceptions still apply.

No surrogate or disputed authority

Under § 36-3231(B), when no listed person can be located, the attending physician may decide after consulting an institutional ethics committee and obtaining its recommendations. If that cannot be done, consultation with a concurring second physician is the alternative. This fallback depends on a failed search for listed people, not simply a disagreement with an available surrogate.

What trips people up

The patient's directive and known wishes remain central under § 36-3231(A): the provider seeks the directive before applying the default order, and a listed surrogate must follow known wishes. The physician fallback in subsection B also has a sequence: seek the committee's recommendations first, then use a concurring second physician if committee consultation is not possible.

Common questions

Does a domestic partner outrank a parent? No. Section 36-3231(A)(3)–(4) places a parent first, and the domestic-partner class applies only if the patient is unmarried.

Can a close friend decide without a signed appointment? Section 36-3231(A)(6) allows a qualifying close friend to serve after the listed family classes; the provider must still make the required reasonable contact efforts.

Can a physician decide merely because relatives disagree? Section 36-3231(B) authorizes that fallback if the provider cannot locate any person in subsection A. It does not say that disagreement alone triggers it.

Statutes and sources

• Ariz. Rev. Stat. § 36-3231. Verbatim official text, source link, and access date appear in the source fields above.