All Roll Calls
Yes: 169 • No: 3
UtahS.B. 1342025 General SessionSenate
Health Care Decisions Act Amendments
Sponsored By: Michael K. McKell (Republican)
Signed by Governor
Health and Human ServicesHealth CareHealth Care FacilitiesMedical RecordsAdvance Health Care DirectiveMental HealthHealth Care ProfessionalsJudicial OperationsProbateHealth Facility AdministratorsPower of Attorney
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Bill Overview
Analyzed Economic Effects
16 provisions identified: 12 benefits, 0 costs, 4 mixed.
Patients can recover damages for interference
The law bans falsifying directives, coercion or fraud, and requiring or banning a directive as a condition of care. Unauthorized concealment or alteration is banned when intended, or known likely, to defeat the creator's wishes. Affected people or estates can recover $25,000 or actual damages, whichever is greater; intentional provider violations of duties to honor care decisions allow $50,000 or actual damages, whichever is greater. Winning plaintiffs can also recover reasonable attorney fees, court costs, and litigation expenses. Emergency medical providers are exempt for noncompliance when they reasonably believe life or serious harm is immediately threatened, follow accepted standards, and care did not begin in an institution where the patient lived or received care.
Death benefits protected after care withdrawal
Beginning January 1, 2026, death caused by withholding or stopping care under this law is not suicide or homicide. Such a death cannot invalidate or weaken an insurance policy or annuity that provides a death benefit. This protection applies even if the contract says otherwise. It protects beneficiaries without setting a payment amount.
Care representatives must follow your wishes
Agents and default decision-makers must follow your instructions and known wishes, or your best interests, considering your current communications and values. Their authority generally starts when you lack capacity and ends when capacity returns or you object; a confirmed finding or court ruling can restore authority, and your power of attorney can start an agent's authority earlier. They can access information you could access and apply for health insurance or benefits only if nobody else is authorized, without a duty to apply. Providers must reasonably search for a representative, record key changes, and communicate care decisions when possible; representatives must promptly report known revocations or disqualifications. Courts can stop improper decisions, require valid decisions, or bar an unfit representative; supporting withdrawal of care alone does not prove an agent is dangerous.
Choose and change your care agent
You can appoint health care agents and backups; co-agents can act independently unless your power of attorney says otherwise. You and an eligible adult witness must sign; remote witnessing is allowed, with identity checks for audio-only witnessing. Conflict rules exclude dangerous agents and certain facility workers, with family and cohabitant exceptions for agents. You can revoke instructions or appointments through a clear act unless a court or confirmed finding establishes that you lack capacity to revoke. A spouse's appointment ends after listed marital proceedings, recorded legal separation, or willful desertion exceeding one year, unless your directive says otherwise. Your agent's decisions need no court approval and outrank a guardian's unless a court orders otherwise; guardians need an express court order to reject or revoke your directive.
Clear steps for life support orders
Life-sustaining treatment orders must use a dated, state-designated form stating the level of care, including care to withhold or stop. Preparation requires consultation with the person authorized to consent; physicians, advanced practice nurses, physician assistants, and authorized supervised providers can prepare orders. A qualified clinician must sign, along with the capable adult or directed signer, the highest-priority surrogate or class majority or their directed signer, or a minor's parent or guardian. Electronic signatures are allowed. When in-person or electronic signing causes significant difficulty or expense, verbal confirmation can replace the consent signature if a separate licensed provider witnesses, documents, and verifies identity under federal privacy standards.
Families get rules for care decisions
When you lack capacity and no authorized agent or guardian is available, a qualified default decision-maker can act unless your directive says otherwise. Priority runs through your chosen adult, spouse, adult child, parent, cohabitant, adult sibling, adult grandchild or grandparent, qualifying adult stepchild, six-month decision-making helper, another caring adult familiar with your values, then a designated physician. Spousal eligibility has separation and divorce limits; stepchildren need a prior parenting relationship and ongoing ties. You can clearly reject someone even without capacity to create a directive; danger findings, certain facility roles, or refusal of a required declaration also disqualify people. Same-priority disagreements follow the majority of communicating members acting properly; ties require seeking remaining available views, then other Utah law. An institution can use an independent physician only after searches fail, ethics committee agreement, notice of your objection right, and documentation; authority ends when a higher-priority person becomes available, you leave, or eligibility ends.
Life-support protections for people with long-term disabilities
Beginning January 1, 2026, the law protects certain ongoing treatments for people with long-term disabilities. It covers artificial nutrition, hydration, or mechanical ventilation routinely used without objection. An agent or default decision-maker cannot approve withholding or stopping these treatments unless an exception applies. Exceptions cover treatment no longer needed to sustain life or well-being, or clear permission in an instruction not revoked. Another exception covers major, nonrecoverable health or ability loss, without conflicting directions or an expressed wish to keep treatment.
Older care plans keep legal protection
Beginning January 1, 2026, Utah replaces older health care decision laws with a new framework covering directives from any date. Older directives remain valid if they follow this law or followed the law where they were created at that time. The law preserves the validity and effect of actions taken before January 1, 2026. Existing default decision-makers can continue until the patient regains capacity or the decision-maker is disqualified, whichever happens first. Utah law in effect when a directive is used governs its meaning, excluding Utah's rules for choosing another state's law.
Patients can challenge lost decision rights
The law presumes you can decide if you can communicate and understand the decision, using help or accommodations when needed. A contrary clinical finding generally needs a current exam, qualified professional, and signed explanation; family members and surrogates cannot make it. You must receive prompt notice, and capacity is presumed again when the reason for the finding ends. You can object by words, writing, or a clear act; capacity is restored unless you withdraw the objection, a court rules otherwise, urgent serious harm requires action, or an independent second finding confirms incapacity. A second finding cannot justify stopping life-sustaining treatment you requested, and objections must be recorded. You or others concerned with your care can seek prompt court review; the court must appoint counsel if needed and require clear and convincing evidence.
Patients control longer stays and admissions
Your agent or default decision-maker needs your specific recorded permission to approve voluntary mental health facility admission. Admission cannot exceed the maximum number of days your directive allows. Without specific recorded permission, they cannot approve nursing home placement intended to exceed 100 days if a reasonable living alternative exists, you object, or you are not terminally ill. Separate limits protect people with long-term disabilities against representative-approved withdrawal of artificial nutrition, hydration, or mechanical ventilation. Exceptions include treatment unnecessary for life or well-being, express authorization, or a major decline consistent with withdrawal and no conflicting instructions.
Plan ahead for mental health care
You can make a directive just for mental health care and name an agent limited to those decisions. It can address medication, crisis care, care refusals, facilities, and admission length. Later instructions control only where they conflict with earlier instructions. Appointing an agent only for mental health does not cancel an earlier agent for other care, or vice versa. A later appointment covering mental health replaces earlier mental health authority unless the later power of attorney says otherwise.
Your care instructions travel more easily
You can record future care wishes, including preferred providers, people to consult, and choices for a guardian or default decision-maker. Providers receiving instructions must record them and their date; later instructions replace earlier ones only where they conflict. Utah recognizes out-of-state directives that follow the state law named in them, the creation state's law if none is named, or Utah law. Electronic records cannot be rejected just because they are electronic, and paper or electronic copies carry the same force as originals. You can certify a paper copy of an electronic directive or revocation by affirming its completeness and accuracy under penalty of perjury.
Providers must honor wishes or transfer
Providers must follow your valid care instructions, a surrogate's reasonable interpretation, and properly made surrogate decisions. They can refuse for listed reasons, including unavailable care, accepted medical standards, law or court orders, and permitted religious or moral objections. Institutional conscience policies must be communicated in time. Refusing providers must notify you when possible and your surrogate, immediately seek a willing provider, and continue required care during transfer. For the specified conscience-refusal category, if transfer cannot reasonably be made, required life-sustaining and comfort care must continue for at least 10 days after refusal.
Treatment orders control conflicting care plans
A life-sustaining treatment order controls whenever it conflicts with an advance health care directive. Adults, and parents or guardians of minors, can revoke orders through listed spoken, written, physical, witnessed, or replacement-order actions. A surrogate must reflect the adult's wishes and cannot revoke an order from the emergency assistance call until the emergency ends. Death following lawful withholding or withdrawal of care is not suicide or homicide and does not invalidate life insurance or annuities. The law does not authorize assisted suicide or euthanasia.
Two doctors must review children's orders
An order to withhold or stop life-sustaining treatment for a minor must include certifications from two physicians. Each physician must state that the decision is in the child's best interest based on clinical judgment.
Good faith shields care decision makers
Providers and institutions receive liability and discipline protection for good-faith decisions based on reasonable beliefs about authority, capacity, directive validity, or representative availability. Agents, default decision-makers, and people reasonably believing they hold those roles receive protection when trying in good faith to follow their duties. Providers are also protected for following life-sustaining treatment orders in good faith or giving life-sustaining treatment despite an order to withhold it. Emergency medical providers must hold required licenses or certifications. These shields reduce legal exposure for decision-makers but limit patients' ability to obtain remedies for covered actions.
Sponsors & Cosponsors
Sponsor
Michael K. McKell
Republican • Senate
Cosponsors
Jordan D. Teuscher
Republican • House
Roll Call Votes
Senate vote • 2/27/2025
Senate/ concurs with House amendment
Yes: 24 • No: 1
House vote • 2/26/2025
House/ passed 3rd reading
Yes: 69 • No: 0
House vote • 2/26/2025
House/ uncircled
Yes: 0 • No: 0
House vote • 2/26/2025
House/ circled
Yes: 0 • No: 0
House vote • 2/13/2025
House Comm - Favorable Recommendation
Yes: 12 • No: 0
House vote • 2/13/2025
House Comm - Substitute Recommendation
Yes: 11 • No: 0
Senate vote • 2/7/2025
Senate/ passed 3rd reading
Yes: 23 • No: 1
Senate vote • 2/6/2025
Senate/ substituted
Yes: 0 • No: 0
Senate vote • 2/6/2025
Senate/ passed 2nd reading
Yes: 24 • No: 1
Senate vote • 2/6/2025
Senate/ uncircled
Yes: 0 • No: 0
Senate vote • 2/4/2025
Senate/ circled
Yes: 0 • No: 0
Senate vote • 1/27/2025
Senate Comm - Amendment Recommendation
Yes: 3 • No: 0
Senate vote • 1/27/2025
Senate Comm - Favorable Recommendation
Yes: 3 • No: 0
House vote • Unknown
House/ uncircled
Yes: 0 • No: 0
House vote • Unknown
House/ circled
Yes: 0 • No: 0
Senate vote • Unknown
Senate/ substituted
Yes: 0 • No: 0
Senate vote • Unknown
Senate/ uncircled
Yes: 0 • No: 0
Senate vote • Unknown
Senate/ circled
Yes: 0 • No: 0
Actions Timeline
Governor Signed
3/26/2025Senate/ to Governor
3/13/2025SenateSenate/ received enrolled bill from Printing
3/13/2025SenateSenate/ enrolled bill to Printing
3/4/2025SenateEnrolled Bill Returned to House or Senate
3/4/2025Draft of Enrolled Bill Prepared
3/3/2025Bill Received from Senate for Enrolling
3/3/2025Senate/ signed by President/ sent for enrolling
2/27/2025SenateSenate/ received from House
2/27/2025SenateHouse/ to Senate
2/27/2025HouseHouse/ signed by Speaker/ returned to Senate
2/27/2025HouseHouse/ received from Senate
2/27/2025HouseSenate/ to House
2/27/2025SenateSenate/ concurs with House amendment
2/27/2025SenateSenate/ placed on Concurrence Calendar
2/26/2025SenateSenate/ received from House
2/26/2025SenateHouse/ to Senate
2/26/2025HouseHouse/ passed 3rd reading
2/26/2025HouseHouse/ uncircled
2/26/2025HouseHouse/ circled
2/26/2025HouseHouse/ 3rd reading
2/26/2025HouseHouse/ 2nd reading
2/20/2025HouseHouse/ Rules to 3rd Reading Calendar
2/20/2025HouseHouse/ return to Rules due to fiscal impact
2/14/2025HouseHouse/ comm rpt/ substituted
2/14/2025House
Bill Text
Enrolled
3/4/2025
Substitute #2
2/13/2025
Substitute #1
1/31/2025
Amended 1/28/2025 09:01:849
1/28/2025
Introduced
1/16/2025