MARCH 2026 | 15 THE OKLAHOMA BAR JOURNAL Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff. Advance Directives Advance directives are legal documents that not only name a trusted medical decision-maker but also allow the principal to make legally enforceable endof-life decisions in advance of a medical crisis.5 Specifically, an advance directive allows a principal to choose when lifesaving measures should be stopped if they are medically incapable of making their own decision while in one of the following states: 1) a terminal illness with no reasonable expectation of recovery, 2) a persistent vegetative state or 3) an end-stage condition that results in incompetency and complete physical dependency. In some jurisdictions, HPOAs and advance directives are included in the same statutory form, which leads to the powers being discussed interchangeably. In Oklahoma, however, the powers are controlled by two separate statutes and statutory forms,6 which can lead to the accidental exclusion of end-of-life decision- making if only an HPOA is written. Notably, the Oklahoma statutory HPOA form specifically advises that it cannot be used to make decisions regarding artificial nutrition and hydration (tube feeding and IV). Instead, these choices must be set forth and initialed separately, substantially following the statutory advance directive form. The importance of this decision is magnified for principals who express fear of “being kept alive in a vegetative state,” similar to the case of Terri Schiavo.7 Oklahoma law prohibits the removal of artificial nutrition and hydration under such circumstances, unless an advance directive has been written.8 As withholding artificial nutrition and hydration may be the only way to allow a principal in such a state to die naturally, choosing to draft an advance directive over (or in addition to) an HPOA is critical. HPOA and Advance Directive Combination While Oklahoma’s statutory advance directive form must be
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