A declaration becomes operative when: (i) it is communicated to the attending physician; and, (ii) the declarant is determined by the attending physician and another physician in consultation either to be in a terminal condition and no longer able to make decisions regarding administration of life-sustaining treatment or to be permanently unconscious. When the declaration becomes operative, the attending physician and other healthcare providers shall act in accordance with its provisions or comply with the transfer provisions of § 20-17-207.