Advance Directives - Combined Advance Directive Laws

Some states have separate laws that govern living wills and durable powers of attorney for health care. The National Conference of State Legislatures (NCSL) and the Center to Improve Care of the Dying (CICD) believe that rather than having separate laws for these two documents, states should combine right-to-die laws into a single statute. By September 2004, twenty-two states had done just that. (See Table 7.2.) Of these states, Alabama, Alaska, Delaware, Hawaii, Maine, Mississippi, and New Mexico had also adopted the Uniform HealthCare Decisions Act (UHCDA) as a model.

The UHCDA has been recommended by the NCSL and the CICD as a model law because it is simple and comprehensive. It contains provisions governing living wills and durable powers of attorney, as well as limits on an agent's powers. The law permits instructions regarding one's future health care to be either written or oral. States using the law as a model may adopt the optional combined directive, which does not require witnesses to the document. It further enables individuals to express their preferences about organ donation and to designate a primary physician. (See Table 7.1, Part 3 and Part 4.)

Along with showing the type of health care power of attorney and combined advance directive legislation in each state, Table 7.2 shows other related information, including the comity provision. If a state has a comity provision, it has legislation specifically requiring that another state's living will, a health care power of attorney, or both, be honored within their borders.