Living Will

California: a written directive is dated and signed by the patient, or in the patient's name by another adult in the patient's presence and at the patient's direction.

What an ADVANCE HEALTH CARE DIRECTIVE is in California: either an individual health care instruction or a power of attorney for health care, or both in one document. California combines the two instruments;

Health Care Decisions Law definition: an individual health care instruction is a patient's written or oral direction concerning a health care decision for the patient.

The witness restrictions: not the patient's health care provider or their employee, not the operator or employee of a community care or residential care facility, not the appointed agent, and at least one witness who is…

How a directive is revoked, including that the designation of an agent may be revoked only in a signed writing or by personally informing the supervising health care provider.

CALIFORNIA'S STATUTORY ADVANCE HEALTH CARE DIRECTIVE FORM, covering appointment of an agent, individual instructions about end-of-life care, organ donation and designation of a primary physician. Start from it;

The Secretary of State maintains a registry in which a person who has executed a written advance health care directive may register information about it, available on request to a health care provider, the public…

Unless a written advance health care directive specifies otherwise, a determination that a patient lacks or has recovered capacity, or that another condition exists that affects an individual health care instruction or…

An adult having capacity may give an individual health care instruction, which may be oral or written and may be limited to take effect only if a specified condition arises.

Except as provided in sections 4734 and 4735, a health care provider or institution caring for a patient must comply with the patient's individual health care instruction and a reasonable interpretation of it made by a…

Connecticut rule that no physician, health care provider or health care insurer shall require a person to execute a living will or appoint a health care representative as a condition of treatment or of receiving health…

How earlier advance directives, appointments of a health care agent and powers of attorney for health care remain valid. Check before telling a client their older document is worthless.

The statutory form for health care instructions, the living will half of a Connecticut directive. Section 19a-575a's combined form is usually the better starting point because it also appoints a representative.

THE FORM TO USE. One document carrying health care instructions, the appointment of a health care representative, the designation of a conservator for future incapacity, and an anatomical gift.

How a living will or appointment is proved and the physician's role in determining incapacity. Background to when the document actually operates.

It becomes operative only when the document is FURNISHED to the attending physician or APRN AND the declarant is determined by them to be incapacitated. A signed directive in a drawer does nothing.

Connecticut rule that sections 19a-571 and 19a-573 to 19a-575a create no presumption about the wishes of a patient who has not executed a document described in 19a-575 or 19a-575a.

The standalone statutory form for appointing a health care representative, for a client who wants only the appointment and not the full combined document.

A living will may be revoked at any time, in the manner the section provides, and the section protects those acting without knowledge of a revocation. Capacity is not the barrier to revoking that clients expect.

A directive executed in another state or country is given effect as the section provides. Relevant for a client who moved to Connecticut.

Delaware rule that an individual may create an advance directive addressing only mental health care, containing a health-care instruction (preferences on professionals, facilities, admission, medications, refusals and…

Delaware rule that an advance directive created outside Delaware is valid if it complies with the law of the state it names (or where it was created) or with Delaware's chapter, that a person may assume without inquiry…

The instruction half of a Delaware directive: the client's own directions about treatment. Read with the optional form in section 2511.

Delaware: section 2508 requires the health care power to be in a record signed by the individual and an adult witness.

The provider's duties on receiving a directive, including recording it and complying or transferring. Encourage the client to give a copy to their physician while well.

The Act's defined terms, including advance health-care directive, agent, health-care instruction and surrogate. Delaware combines the instruction and the appointment into one ADVANCE HEALTH-CARE DIRECTIVE;

How a directive or an agent's appointment is revoked, including the effect of divorce or annulment on a spouse agent. A divorcing client who still wants their spouse to decide must say so expressly.

Delaware rule that an agent or default surrogate owes the individual a fiduciary duty and must decide in accordance with the individual's advance directive and other known or reasonably ascertainable goals, preferences…

What the agent or surrogate may decide, subject to any limits in the directive. Read with section 2519's limitations before promising a client what their agent can do.

Co-agents and alternates. Name an alternate: a directive with a single agent fails exactly when the agent is unavailable.

District of Columbia text: an attending physician notified of a declaration must, after diagnosing a terminal condition, provide for written certification and confirmation of the condition so the declarant may become a…

District of Columbia: section 21-2205 requires a dated health care power signed by the principal and two adult witnesses who affirm sound mind and freedom from duress.

Provides an optional statutory form for the health-care power of attorney, requiring the principal's signature, two witnesses who personally know the principal and attest to capacity and absence of duress, and at least…

Requires the natural death declaration to be signed and dated, with two or more witnesses at least 18 years old, disqualifying relatives, estate beneficiaries, those financially responsible for the declarant's care, the…

A declaration may be revoked by physical destruction, by signed written revocation effective on physician notification, or by an oral revocation witnessed by an adult who documents it in writing, also effective on…

Defines terms for the Health-Care Decisions chapter, including attorney in fact as the person receiving health-care decision authority, incapacitated individual, and durable power of attorney for health care as…

Gives the health-care attorney in fact authority to consent to, refuse, or withdraw treatment, access records, and make provider and facility decisions, requiring the agent to follow the principal's expressed wishes or,…

A principal may revoke the attorney in fact's appointment by oral or written notice, and the health-care POA is automatically revoked by dissolution, annulment, or termination of the principal's marriage or domestic…

District of Columbia Natural Death Act text: a declaration has no effect if the declarant is a patient in an intermediate care or skilled care facility when it is executed unless one of the two witnesses is a patient…

District of Columbia text: a qualified patient's desires always supersede the declaration;

Florida text providing that an advance directive executed in another state in compliance with that state's law or Florida law is validly executed for purposes of chapter 765.

A Florida LIVING WILL must be signed by the principal in the presence of TWO SUBSCRIBING WITNESSES, AND ONE OF THEM MAY BE NEITHER A SPOUSE NOR A BLOOD RELATIVE.

Florida text requiring the patient's primary physician and at least one other consulting physician to separately examine the patient to determine whether the patient has a terminal condition, has an end-stage condition,…

The advance directive chapter's defined terms, including health care surrogate, end-stage condition, persistent vegetative state and terminal condition. Those three conditions are the triggers for a living will;

How an advance directive is amended or revoked, including by a later directive or by physical act. Capacity is not the barrier clients expect.

Florida text requiring health care facilities to give patients written information on advance directive rights and document whether an advance directive exists, barring providers and facilities from requiring a patient…

Florida: a surrogate designation under section 765.202 is signed in the presence of two subscribing adult witnesses; a principal unable to sign may direct another to sign in the witnesses' presence.

A parent may designate a health care surrogate for a MINOR CHILD, which is a distinct Florida instrument. Raise it with any client who has children and travels or leaves them with caregivers.

The suggested living will form, with initial lines for the terminal condition, end-stage condition and persistent vegetative state triggers.

How the living will operates once the physician determines the triggering condition. The document must reach the physician to do anything.

An advance directive may be revoked at any time by a signed and dated written or electronic document, by physical cancellation or destruction, by an oral statement to a health care practitioner, or by executing a later…

Maryland text: a health care provider that intends not to comply with an instruction of a health care agent or surrogate must tell the person that it declines, that a transfer may be requested and that it will make…

Maryland text: an advance directive, emergency medical services do not resuscitate order or order regarding life-sustaining treatment executed in another state is deemed validly executed if it complies with Maryland law…

The section sets out Maryland's optional advance directive form in full: Part A appointing a health care agent with the scope and effective time of the agent's authority, Part B the living-will treatment preferences…

Maryland: the ordinary written or electronic directive is dated, signed by or at the declarant's express direction, and subscribed by two witnesses in the declarant's physical or electronic presence.

Before treatment authorized under this subtitle is provided, withheld or withdrawn, the attending physician and a second physician or nurse practitioner must certify in writing, on personal examination, that the patient…

Maryland text: willfully concealing, canceling, defacing, obliterating or damaging another's advance directive without consent, or forging a revocation, thereby causing life-sustaining procedures to be used against the…

Maryland text: withholding or withdrawing life-sustaining procedures under the Health Care Decisions Act is not suicide for any purpose;

Maryland text: an individual may register an advance directive with an electronic advance directives service recognized by the Maryland Health Care Commission and must notify the service of amendment or revocation;

A gift may be amended or revoked by a later signed record, destruction of the document with intent, an oral statement during terminal illness, ordinary will amendment for a will-based gift, or written notice to the…

Massachusetts: a competent adult's written health care proxy is signed by the adult or at the adult's direction in the presence of two other adults who subscribe as witnesses under chapter 201D, section 2.

Massachusetts rule that a person may not require or prohibit the execution of a health care proxy as a condition for providing health care services or insurance to an individual. Signing a proxy is voluntary.

What happens where a physician declines to honour the proxy, including the duty to transfer. Encourage the client to discuss the proxy with their physician while well.

What the proxy must contain: identification of the principal and agent, a statement that the principal intends the agent to have authority to make health care decisions, and the section's other required elements,…

How a proxy is revoked, including by a later proxy, by notification, or by DIVORCE or legal separation where the spouse was the agent, unless the principal specified otherwise.

The health care proxy chapter's defined terms, including health care agent, health care decision and attending physician. Massachusetts says HEALTH CARE PROXY and HEALTH CARE AGENT; use its vocabulary.

Massachusetts rule that nothing in the health care proxy chapter precludes any medical procedure the attending physician deems necessary for comfort care or pain alleviation, including sedatives and pain-killing drugs,…

Massachusetts rule that a private facility need not honor an agent's decision it would not honor if made by the principal because the decision is contrary to a formally adopted policy expressly based on religious…

What the chapter does and does not say about a patient with no proxy. This is the default a client gets by doing nothing, and in Massachusetts it is thinner than in states with a statutory surrogate list, which is the…

Who may serve as health care agent, with the section's limits on operators, administrators and employees of facilities where the principal is a patient or resident, unless related to the principal.

An advance directive becomes operative only when it has been transmitted to the attending physician or the health care institution and it has been determined under 26:2H-60 that the patient lacks capacity to make the…

A psychiatric advance directive must be signed and dated by the declarant and witnessed by an adult attesting that the declarant is of sound mind and free of duress, and the designated mental health representative and…

New Jersey: date and sign the advance directive by or at the direction of the declarant.

The attending physician, the health care representative and any additional physician responsible for the patient's care must discuss the nature and consequences of the patient's condition and the risks, benefits and…

A declarant may reaffirm or modify a proxy or instruction directive only with the formalities required for execution under 26:2H-56, but may revoke one orally or in writing to the health care representative, a…

The attending physician determines whether the patient lacks capacity for a particular health care decision, must state that determination in writing with an opinion on the nature, cause, extent and probable duration of…

Department of Health guidance and links to proxy and instruction directives. The page states its last review date; compare its guidance with the statutes and current clinical circumstances.

Where the patient executed an instruction directive but named no health care representative, or none is able or available, the instruction directive is legally operative on its own and must be honoured according to its…

Consistent with the advance directive, life-sustaining treatment may be withheld or withdrawn when it is experimental and not a proven therapy, is likely to be ineffective or futile, or is likely merely to prolong an…

The absence of an advance directive creates no presumption about a patient's wishes regarding the provision, withholding or withdrawing of any form of health care, and the act does not apply to a person who has not…

New York: the principal dates and signs the proxy in the presence of two adult witnesses, who also sign and state that execution appeared willing and free of duress.

The agent's authority begins when the attending practitioner determines to a reasonable degree of medical certainty that the principal lacks capacity, records the determination and its cause, extent and probable…

The Department's optional health care proxy form, with the agent and alternate designation, the artificial nutrition and hydration statement that PHL 2982 makes necessary, the duration and organ-donation options, and…

MOLST is a physician order set, valid in all settings including by emergency medical services, that translates a seriously ill patient's wishes into actionable orders about resuscitation, intubation, hospitalisation and…

Defines health care agent, health care decision, health care proxy, attending practitioner, reasonably foreseeable and the other terms article 29-C uses, including the reach of health care decision over the withholding…

The agent may make any health care decision the principal could make, after consultation with a physician or other listed practitioner, in accordance with the principal's wishes including religious and moral beliefs, or…

A competent adult may revoke a proxy by notifying the agent or a health care provider orally or in writing or by any act evidencing an intent to revoke, by executing a later proxy, and a proxy naming a spouse is revoked…

Definitions for article 29-CC: "life-sustaining treatment" is any medical treatment or procedure without which the patient will die within a relatively short time, as an attending physician determines, and…

Article 29-CC applies to health care decisions in a hospital, and to hospice decisions wherever made, for a patient who lacks decision-making capacity, and to do-not-resuscitate decisions in mental hygiene hospitals;

Every adult is presumed to have decision-making capacity; an attending practitioner makes the initial determination of incapacity to a reasonable degree of medical certainty, independent concurring determinations are…

The defined terms for Ohio's health care power of attorney. Ohio keeps the health care power in chapter 1337 alongside the financial one but executes it differently; do not assume one set of formalities covers both.

What the health care attorney in fact may decide, including the specific conditions the section imposes before life-sustaining treatment may be withheld or withdrawn, and the express statement required for nutrition and…

OHIO'S LIVING WILL, called a DECLARATION. It must be signed at the end by the declarant or another at their direction, state the DATE of execution, and either be witnessed as the section requires or be ACKNOWLEDGED…

The declaration operates only when the declarant lacks capacity and the attending physician and a second physician make the determinations the section requires. A signed declaration in a drawer does nothing.

Ohio's printed statutory form for the health care power of attorney, with the notice to the principal the statute requires. Start from it.

Ohio text allowing a declarant to revoke a declaration at any time and in any manner, effective when the declarant expresses the intent to revoke, except that if the attending physician knew of the declaration the…

What the attending physician and a second physician must determine before a declaration operates, and the physician's duties once it does. The declaration does nothing until those determinations are made and recorded.

Where there is no declaration and no attorney in fact, this priority list decides. It is the default a client gets by doing nothing; walking through the order usually persuades a reluctant client to sign.

Ohio text treating a declaration executed under another state's law in compliance with that law, or in substantial compliance with sections 2133.01 to 2133.15, as valid for purposes of the Ohio statute.

Ohio: the health care power under section 1337.12 is signed at the end and dated. The principal signs or acknowledges the signature in each qualifying witness's presence, then the witnesses subscribe after the…

Unless the document says otherwise, it becomes operative when a copy reaches the attending physician AND the physician determines the principal is incompetent, and it becomes inoperative when the principal regains…

The physician must certify an end-stage medical condition or permanent unconsciousness in writing and record health care decisions in the medical record. The certification is what makes the client's document operate.

Text of the statutory example of a combined document, Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will): Part I gives introductory remarks on health care decision making and a…

Health care providers, health care service plans, health maintenance organizations, disability insurers, self-insured employee welfare benefit plans, nonprofit hospital plans and government-sponsored health programs may…

A living will only becomes operative when a copy reaches the attending physician AND the physician determines the principal is incompetent and either has an end-stage medical condition or is permanently unconscious.

The agent may make any health care decision the principal could make, including admission to a facility, and the authority can extend past death to anatomical gifts, disposition of remains and consenting to autopsy.

The defined terms that drive the whole chapter, including advance health care directive, attending physician, end-stage medical condition, life-sustaining treatment and permanently unconscious.

Notwithstanding a living will or an agent's decision, life-sustaining treatment, nutrition and hydration must be provided to a pregnant woman who is incompetent and has an end-stage medical condition or is permanently…

Texas definitions for chapter 166, including advance directive (a directive, an out-of-hospital DNR order, or a medical power of attorney), artificially administered nutrition and hydration, attending physician,…

Texas text giving an advance directive or similar document validly executed in another state or jurisdiction the same effect as one validly executed under Texas law, without authorizing health care otherwise prohibited…

Texas text providing that when a treatment decision or advance directive validly made under chapter 166 conflicts with another, the decision made or document executed later in time controls.

Texas text defining a directive as an instruction made under section 166.032, 166.034, or 166.035 to administer, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition, and…

Texas: a directive to physicians under section 166.032 and a medical power of attorney under section 166.154 have separate execution provisions.

The statutory form of the Directive to Physicians, Living Will and Advance Directive. Start from it; it carries the choices and the explanations the statute expects.

A Texas directive need NOT be notarised, and no health care provider or facility may require a particular form.

Texas text allowing a declarant to revoke a directive at any time without regard to mental state or competency, by destroying it or having it destroyed in the declarant's presence and at the declarant's direction, by a…

The principal signs in the presence of two qualifying witnesses, who also sign, or acknowledges the signature before a notary. At least one witness must satisfy section 166.003(2).

Each witness must be a competent adult; at least one must satisfy the listed relationship, care-provider and estate-interest restrictions. Read with the execution provision for the particular directive.

A declarant capable of understanding the nature and consequences of his actions may revoke an advance directive at any time by a signed and dated writing, by physical cancellation or destruction by himself or by another…

Virginia: a written advance directive is signed by the declarant in the presence of two subscribing witnesses under section 54.1-2983. Confirm the adult declarant's ability to make and communicate an informed decision;

Optional suggested statutory form. Select the client's choices explicitly; do not grant every optional power by default. Some powers over protest include separate physician or psychologist attestations.

A directive cannot authorize nontherapeutic sterilization, abortion or psychosurgery, and any provision conflicting with an emergency custody, temporary detention or involuntary admission order under Title 37.2 is void…

Without a directive, health care decisions fall to a statutory list in order: guardian, spouse, adult child, parent, sibling, other relative, and in limited cases a close friend, with stricter rules at the end of life.

A physician may refuse care he determines medically or ethically inappropriate, but only BASED SOLELY ON THE PATIENT'S MEDICAL CONDITION.

Virginia text: on petition of any person to the circuit court where the patient resides or is located, the court may enjoin providing, continuing, withholding or withdrawing health care under the Health Care Decisions…

Virginia text: willfully concealing, canceling, defacing, obliterating or damaging another's advance directive or Durable Do Not Resuscitate Order without consent, or falsifying or forging a directive, order or…

Virginia text: a person may file a health care power of attorney, an advance directive under the Health Care Decisions Act, an anatomical gift declaration or other advance-planning documents such as a Durable Do Not…

Virginia text: failing to register a document with the Department of Health's registry does not affect the document's validity, and failing to notify the Department of a revocation does not affect a revocation that…