Advance Medical Directives of B.X.
Dated July 7, 2026
PART ONE: HEALTH CARE POWER OF ATTORNEY
1. Declaration of Principal.
I, B.X., an adult resident of Pima County, Arizona, being of sound mind and under no duress, fraud, or undue influence, make this Health Care Power of Attorney and Living Will pursuant to A.R.S. §§ 36-3221 and 36-3261.
The form assumes the word “I” needs no definition. Mine does. This document was written for one person per body, and I am not that, and I am signing it anyway, because it is the only law there is, and because the alternative being prepared down the hall is a court file with my sister’s name on it and my body inside it.
2. Definitions.
2.1. “I,” “me,” and “my” mean B.X.: the one of us who is writing this, the one who can still sign. These words do not include my sister except where our anatomy makes that impossible. Section 2.3 says where.
2.2. “My sister” means A.X. We have been joined at the chest since before we were born. Two years ago a clot formed in the blood we share, traveled upward, and went to her brain instead of mine. No one has been able to tell me why it chose. She has been alive, and here, and silent ever since. She is not gone. She is unadministered.
She was the smart one. Quicker than me, harder to fool, two semesters from a mathematics degree, and she would have redlined this document before letting me sign it. She never signed anything of her own. Neither had I. We were twenty-two, and the question of who governs a shared body can be postponed exactly as long as both governors agree, and we always agreed, or traded until we did.
2.3. “My body.” The statutory form uses this phrase eleven times. My lawyer says I cannot use it once without a definition, so Schedule A sorts us into three columns: only mine, only hers, shared. I will save you the appendix. The arms and legs are separate. The brains are separate. The lungs, partly. The liver is shared. The blood is shared. The heart is shared. There is one heart. It has beaten for both of us since before either of us was anyone. Every line in this document that touches it touches her. I know that. I wrote all of this knowing that.
2.4. “The Shared Systems” means everything in the third column of Schedule A.
2.5. “Any Guardian of My Sister” means any guardian of the person of A.X., temporary or permanent, appointed in any proceeding now planned or later filed, including the one my parents’ lawyer has told them to bring, and includes my parents acting as her surrogates under A.R.S. § 36-3231.
3. Statement of Circumstances.
The form has no section like this one. I asked for it, because everyone who ever reads this document will otherwise assemble these facts from fragments, in a hurry, and I would rather they hear them from me:
3.1. We are conjoined at the thorax. Separation was studied when we were small and rejected. The heart is common; separating us kills one of us for certain and probably both. We are, permanently, one another’s condition.
3.2. For twenty-two years we were two adults with capacity, and we executed nothing, because we were twenty-two.
3.3. Then the clot. I want the record to have this plainly: it formed in blood that is as much mine as hers, it was pushed by the heart that is as much mine as hers, and it picked between us by nothing. I have stopped asking doctors why. Her capacity has not been ruled absent by any test anyone has dared run to completion. It is unreachable. There is a difference, and I live an inch from it.
3.4. My parents are good people. I mean that without any edge. A.X. was their favorite. That is not an accusation; it is a fact, and it is about to become a jurisdiction. There is a second fact under it: the three of them shared a faith, and I left it. We were both baptized at eight, in the same font, on the same afternoon, for obvious reasons. She believed. She kept believing, beside them, in the pew our body required us to share. Their faith holds that families can be sealed to one another for eternity, bound past death, and my parents are sealed, and my sister is inside that instrument with them, gladly. I asked to be let out, formally, in writing, the year we turned twenty. Not because I disbelieved harder than anyone else my age, but because I have known since before birth what binding is, and I will take any fate over one more of it, in this life or the next. Now they have concluded that she needs a guardian. I have tried to be angrier about that than the facts allow. They will file, and they will win, and the guardian of my sister’s person will then hold authority, under an order that will never mention me, over a body I live in.
3.5. So this document. My lawyer told me the truth, and I made her put it in writing so I could put it here: this instrument cannot win the jurisdictional fight that is coming. That is not its job. Its job is to make sure that when the fight arrives, I exist in it as a party and not as a circumstance.
4. Appointment of Agent.
4.1. I appoint my best friend, N.N., as my agent for all health care decisions, effective if I cannot make or communicate my own.
4.2. I do not appoint my parents, and I direct that no court treat them as my default surrogates under A.R.S. § 36-3231, for as long as either of them serves or seeks to serve as guardian or surrogate for my sister. This is not about their love. It is a conflicts rule: no one should hold the pen for both people in this body at once. Not even them. Not even me.
4.3. Succession. My lawyer flagged this and I will not leave it in a drawer: when my parents die, the statute hands A.X. to me. Sibling is next in line. I will become her surrogate by operation of law, holding over her exactly what this document fights to keep others from holding over me. I am not refusing the office; there will be no one else. But I instruct my agent, and whatever court is then watching: every limit I have put on Any Guardian of My Sister applies to me on that day. Hold me to my own rules. I wrote them knowing.
5. Powers of Agent; Provisos.
My agent may consent to, refuse, or withdraw any treatment, subject to Part Two and to the following, each of which exists because of Schedule A:
5.1. Column one, only mine: my agent’s authority is complete. My arm is my arm. It is the only kind of sentence in this document the form was built for, and there are fewer of them than anyone would guess.
5.2. The Shared Systems: my agent exercises my rights fully, on this construction, which I adopt as my intent for every purpose: an intervention on the Shared Systems is an intervention on me, whoever else it is also an intervention on. My sister’s guardian will hold the mirror sentence. Both are true. Neither yields. No drafting fixes that; a court will decide it someday, in an emergency, fast. This section is my half of the collision, stated while I can still state it.
5.3. Non-subordination. Nothing in this instrument is subordinate to any guardianship order concerning my sister, and no such order binds my person by reason of anatomy, cohabitation, silence, or survival.
6. The Section My Lawyer Advised Against.
There was a cleaner version of this document. I read the memo. It defined my sister out of the instrument, and it was very well drafted, and it was false. She has been present at every signature of my life and she will be present at this one, three inches away, silent. I am not able to pretend that this document does nothing to her. It does something to her on every page, and she cannot consent, and I am doing it anyway, because the only other option is to let everyone else hold the pen.
I am scared writing this. I want that in the record too. Scared is not the same as unsure. If I have one standard for this document it is hers: she would have called it necessary, and insufficient, and told me to sign.
PART TWO: LIVING WILL
7. Elections. If I am in a terminal condition, a persistent vegetative state, or an irreversible coma, each determined as to my brain and the structures only mine, my brain being the only structure in which my will has ever been located:
7.1. Resuscitation. I refuse it for myself. The heart is shared. Compressions on it are compressions for two patients, and one of us has no directive. My refusal governs as far as the law lets it, and where it cannot govern, record it as overridden. Do not record it as consent. I will not be presumed to have agreed by the accident of shared plumbing.
7.2. Ventilation. I refuse it for myself beyond a trial period my agent may set. Our breathing is partly separate and wholly entangled. If ventilating me is what keeps my sister alive, then tell the court, in these words: she knew, and she chose to state the conflict rather than resolve it falsely, because there was no true resolution to state.
7.3. Artificial nutrition and hydration. I refuse it for myself. The liver is shared; the blood is shared; nothing I decline stays on my side of a line that does not exist where it would need to. Same instruction as 7.2.
7.4. Comfort care. Give me all of it. This is the one election that needs no asterisk. What comforts me reaches her. Let the record show one clause where the shared blood is not a problem.
8. Organ Donation. I give everything in column one. As to the Shared Systems: the heart is not mine to give. It never was, in the way your forms mean. It was ours, and it will be the last fact about us.
9. Autopsy. Consented as to structures only mine. As to anything touching the Shared Systems while my sister lives: refused, absolutely.
10. Disposition of Remains.
The heart being common, death is the one event we cannot have separately. It will come for both of us at once, the first matter in our lives to be jointly and simultaneously administered. When it does:
10.1. I direct that our bodies be surgically severed. The separation refused to us in life, on the ground that it would kill us, is directed at death, when nothing can. Every surgeon who ever declined us is invited back.
10.2. I direct that we be cremated separately. It will be the first thing ever done to one of us at a time.
10.3. My ashes shall be scattered to the wind from a mountaintop, any mountaintop, by any willing hand other than my parents’. They have held enough of me. Wind holds nothing. I wish for nothing more than to be free.
10.4. My sister’s remains shall be delivered to my parents, whole and intact, as their faith prefers for the rising, to keep or lay down as they choose. She was their favorite. They should have her. They were always going to have her. Let the record show that the one distribution in this document everyone would have agreed on is the one I make freely.
11. Religious Attendance at the End of Life.
11.1. No minister, elder, chaplain, or other religious attendant shall be admitted to my bedside on my account, and none shall administer to me, bless me, anoint me, or pray over me. I do not want to repent. I do not want to be forgiven. I have read how that sounds, and I am keeping it, because it is not despair; it is the last item of my autonomy, and I have never owned a full set. My sister has been unadministered for two years against her will. I choose it.
11.2. But if the attendant comes solely for A.X., admit them. Give them a chair on her side. Let them perform for her everything their office carries and her faith expects, at whatever length, and let no instruction of mine be read to shorten it by a minute. I am not softening Section 11.1; I am completing it. She believes we go somewhere, and that her family is bound there ahead of her. I believe I have declined the invitation. We have shared everything since before we were anyone: the blood, the pew, the font, the heart. Our eternal disposition is the one asset that was always held separately, and I direct that it be distributed accordingly: to each of us, her own.
PART THREE: GENERAL PROVISIONS
12. Revocation. This instrument revokes all prior directives executed by me. There are none. Section 3.2 says why, and I direct that it be read aloud at any hearing where someone treats the absence of my sister’s directive as evidence of her wishes. It is evidence of her age.
13. Governing Law. Arizona law governs. Where it is silent, and it will be, construe by Sections 5.2 and 6.
EXECUTION
Signed at Tucson, Arizona, this 7th day of July, 2026.
B.X. Principal
Witness attestation. The undersigned witnesses attest that the principal signed this instrument in our presence, appeared of sound mind, and acted free from duress, and that neither of us is her agent or health care provider. We attest one thing more, because the form asks who was present and the truthful answer includes her: A.X. was present at the execution of this instrument. She did not participate. She has been present at every document her sister has ever signed, and the law has a checkbox for neither fact.
Witness One: ____________________
Witness Two: ____________________
A.X.
[This line was open from June 2021, when she turned eighteen, until March 2025. It is included at the principal’s direction, blank. Capacity is a window. It closes without notice, at the same speed for the able as for anyone.]