Living Wills laws

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
ALABAMA 22-8A Natural Death Act	Any medical procedure or intervention serving only to prolong the dying process and where death will occur whether or not such intervention is utilized; does not include medication or any medical procedure deemed necessary to provide comfort care or pain alleviation	(1) Competent adult; (2) in writing; (3) signed by declarant; (4) dated; (5) signed in presence of 2 or more witnesses over 19; (6) declaration should be substantially in statutory format	Revocable at any time by (1) destruction of document in manner intending to cancel; (2) execution of written revocation by declarant; (3) oral revocation in presence of adult witness (over 19)	Declaration executed in another state is valid if valid under laws of that state	Physician shall permit the patient to be transferred	No criminal, civil, or professional liability for physician acting in good faith pursuant to reasonable medical standards and pursuant to a declaration
ALASKA 18.12 Living Wills and Do Not Resuscitate Orders	Withholding or withdrawal of procedures that merely prolong the dying process and are not necessary for comfort or to alleviate pain; includes the administration of food and water by gastric tube or IV; declaration may provide declarant does not want nutrition and hydration administered intravenously or by gastric tube	(1) Competent; (2) 18 yrs.; (3) signed; (4) witnessed by 2 persons over 18 and unrelated to declarant or acknowledged by a person qualified to take acknowledgments; (5) may be in statutory form	Revocable at any time and in any manner declarant is able to communicate intent to revoke without regard to physical/mental condition; effective upon communication; becomes part of declarant's medical record	Declaration executed in another state in compliance with the law of that jurisdiction is effective	Physician may withdraw after services of another physician have been obtained	Physician causing the withholding or withdrawal of life-sustaining procedures from a qualified patient not subject to civil, criminal, or professional liability. Attending doctor has no right to compensation for services after withholding should have been effective and may be liable to patient and heirs for a civil penalty of less than $1000 plus costs associated with failure to comply with order or declaration; this is exclusive remedy at law for damages.

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
ARIZONA 36-3201 et seq. Living Wills and Health Care Directives	Does not include comfort care or alleviation of pain but may include life-sustaining treatment artificially delaying the moment of death, CPR, drugs, electric shock, artificial breathing, artificially administered food and fluids	(1) Adult; (2) in writing; (3) language clearly indicating intent to create a living will; (4) dated; (5) signed; (6) witnessed by at least one adult or a notary public	Person may revoke health care directive or disqualify a surrogate by (1) written revocation; (2) orally notifying surrogate or health care provider; (3) making new health care directive; (4) any other act demonstrating specific intent to revoke	Health care directive prepared in another state is valid in this state if it was valid where and at the time it was adopted to the extent it does not conflict with the criminal laws of Arizona	Physician must effect prompt transfer to a physician willing to comply	Health care provider making good faith decisions in reliance on apparently genuine health care directive or decision of a surrogate or living will is immune from criminal, civil, and professional discipline for that reliance (unless negligent)
ARKANSAS 20-17-201, et seq.	Any medical procedure or intervention that will serve only to prolong the dying process or to maintain the patient in a condition of permanent unconsciousness	(1) Sound mind; (2) 18 yrs.; (3) signed by declarant; (4) witnessed by 2 individuals	Revocable at any time, in any manner by the declarant without regard to the declarant's mental/physical condition; effective upon communication to attending physician	A declaration executed in another state in compliance with the laws of that state or Arkansas law is validly executed	Physician shall as promptly as practicable take all reasonable steps to transfer care to another physician	Physician whose actions under this chapter are in accord with reasonable medical standards is not subject to criminal, civil, or professional liability with respect to them
CALIFORNIA Probate §4600 et seq. Natural Death Act	Any medical procedure or intervention that will serve only to prolong the process of dying or an irreversible coma or persistent negative state; does not include treatment to alleviate pain or provide comfort care	(1) Sound mind; (2) over 18; (3) signed by declarant; (4) witnessed by 2; (5) declaration shall contain substantially same information as form; (6) operative when declarant in terminal condition as certified in writing by 2 physicians; (7) not effective while patient is pregnant	Revocable at any time in any manner without regard to declarant's mental/physical condition; revocation is effective upon its communication to the attending physician	Declaration executed in another state in compliance with the laws of that state or California law is valid	Physician shall take all reasonable steps as promptly as practicable to transfer the patient to a physician who is willing to comply	Physician is not subject to civil, criminal, or professional liability for acting in good faith pursuant to declaration

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
COLORADO 15-18-102, et seq. Colorado Medical Treatment Decision Act	Any medical procedure or intervention that would serve only to prolong the dying process; it shall not include any medical procedure for nourishment or considered by attending physician to provide comfort or alleviate pain; however, artificial nourishment may be withdrawn pursuant to declaration that artificial nutrition (1) not be provided or continued when it is the only procedure being provided; (2) be continued for a specified period when it is the only procedure being provided	(1) Competent; (2) adult; (3) executed before 2 competent witnesses	Revocable by declarant orally, in writing, or by burning, tearing, cancelling; obliterating, or destroying the declaration			No hospital or physician acting under direction of physician and participating in the withholding or withdrawal of life-sustaining procedures in compliance with a declaration shall be subject to any civil or criminal liability or licensing sanction in the absence of revocation, fraud, misrepresentation, or improper execution.
CONNECTICUT 19a-570, et seq. Removal of Life Support Systems	Any medical procedure or intervention serving only to postpone the moment of death or maintain individual in a state of permanent unconsciousness including artificial means of nutrition/hydration, artificial respiration, CPR, but does not include comfort care and pain alleviation	(1) 18 yrs.; (2) signed; (3) dated; (4) presence of 2 witnesses; (5) in substantially form of §19a-575a	May be revoked at any time in any manner		Physician shall act as promptly as practicable and take all reasonable steps to transfer patient to complying physician.	Physician withholding, removing life-support system of an incapacitated patient shall not be civilly or criminally liable if decision was based on physician's (1) best medical judgment; (2) physician deems patient in a terminal condition; (3) patient's wishes were considered according to an executed document

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
DELAWARE 16 §2501, et seq. Health Care Decisions	Right to refuse medical or surgical treatment via written declaration instructing any physician to cease or refrain from medical or surgical treatment	(1) Legally adult, competent, of sound mind; (2) written declaration; (3) declarant in terminal condition confirmed in writing by 2 physicians; (4) signed by declarant or another person in declarant's presence and at his express direction; (5) dated; (6) 2 or more adult witnesses who state in writing that they are not prohibited from being a witness; (7) not pregnant	Revocable at any time without regard to declarant's mental state or competency by (1) destruction of declaration with intent to revoke; (2) oral statement in presence of 2 persons 18 years or older expressing intent to revoke; (3) written revocation signed and dated by declarant or; (4) new declaration with contrary intent; (5) receipt of emergency treatment	Declarations executed in other states are valid if valid in that state		Physicians or nurses acting in reliance on properly executed document are presumed to be acting in good faith and there is no civil or criminal liability or discipline for unprofessional conduct.
DISTRICT OF COLUMBIA 7-621, et seq. Natural Death Act	Any medical procedure or intervention which would serve only to artificially prolong the dying process and where death will occur whether or not such procedures are utilized; does not include medication or any medical procedure necessary to alleviate pain or provide comfort care	(1) 18 yrs.; (2) in writing; (3) dated; (4) signed; (5) in presence of 2 or more witnesses over 18; (6) declaration should be in substantially the statutory form of §6-2422	Revocable at any time by declarant without regard to declarant's mental state by (1) destruction of documents; (2) written revocation signed and dated; (3) verbal expression of intent to revoke in presence of an 18 year old witness; desires of qualified patient at all times supersede the effect of the declaration		Physician must effect a transfer and failure to do so shall constitute unprofessional conduct	No civil, criminal, professional liability for physician who acts in good faith pursuant to reasonable medical standard and to a declaration made

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
FLORIDA 765.101, et seq. Health Care Advance Directives	Any medical procedure, treatment, or intervention which utilizes mechanical or other artificial means to sustain, restore, supplant a spontaneous vital function and serves only to prolong the dying process of a patient in terminal condition; does not include medication or a medical procedure to provide comfort care or to alleviate pain	(1) Competent; (2) adult; (3) signed by principal; (4) in presence of 2 subscribing witnesses (suggested form in 765.302) one of whom is neither a spouse nor a blood relative	Revocable at any time by principal by (1) signed, dated writing; (2) destruction of the declaration; (3) oral expression of intent to revoke; (4) subsequent advance directive materially different from the previously executed advance directive; (5) divorce revokes the designation of former spouse as surrogate. Revocation effective when properly communicated.	An advanced directive executed in another state in compliance with the laws of that state or Florida is validly executed	Physician should make reasonable efforts to transfer to a health care provider who will comply with the declaration; a physician unwilling to carry out the patient's wishes because of moral or ethical beliefs must within 7 days: (1) transfer the patient and pay the cost of transporting the patient to another health care provider or (2) carry out the wishes of the patient unless provisions of judicial intervention apply	Health care facility, provider or other person who acts under the direction of a health care facility, or provider is not subject to criminal prosecution or civil or professional liability for carrying out a health care decision

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
GEORGIA 31-32-1, et seq.	Any medical procedures or interventions which would serve only to prolong the dying process for a patient in a terminal condition, a coma, or persistent vegetative state with no reasonable expectation of regaining consciousness or cognitive function; may include the provision of nourishment and hydration but shall not include medication or any medical procedure to alleviate pain	(1) Competent; (2) adult; (3) signed by declarant; (4) in presence of 2 competent adults not related to declarant; (5) any declaration constituting declarant's intent shall be honored regardless of the form or when executed	Revocable at any time by declarant without regard to mental state or competency by (1) destruction of document; (2) declarant signs and dates a written revocation expressing intent to revoke; (3) any verbal or nonverbal expression by declarant of intent to revoke which clearly revokes the living will as opposed to a will relating to the disposition of property after death	Any declaration regardless of form which constitutes declarant's intent shall be honored	Advise promptly the next of kin or guardian and at their election make a good faith attempt to effect a transfer or permit the next of kin or guardian to obtain complying physician	No physician acting in good faith in accordance with the requirements of this chapter shall be subject to any civil liability, guilty of any criminal act, or unprofessional conduct
HAWAII 327E-1, et seq. Uniformed Health-Care Decisions Act	Execute declaration directing provision, continuation, withholding, or withdrawal of any medical procedure or intervention including artificial provisions of fluids, nourishment, medication that when administered to patient will only serve to prolong dying process; does not include procedure necessary for patient comfort or relief	(1) Competent person, age of majority; (2) in writing; (3) signed by declarant or another person in his presence and at his expressed direction; (4) dated; (5) signed in presence of 2 or more adult witnesses; (6) all signatures notarized; (7) not pregnant; (8) in terminal condition or permanent loss of ability to communicate concerning medical treatment (sample form §327D-4)	Revocable at any time by various methods including: (1) in writing signed and dated by declarant; (2) unambiguous verbal expression by declarant in front of 2 witnesses; (3) canceling, destroying declaration in declarant's presence and at his direction; (4) unambiguous verbal expression to attending physician	Document executed in another state is valid if it substantially complies with requirements of this chapter	Physician shall without delay make necessary arrangements to transfer patient and medical records to another physician; transfer without unreasonable delay or with good faith attempt to transfer is not abandonment and not subject to liability	No criminal prosecution or civil liability or deemed to have engaged in unprofessional conduct as result of withholding or withdrawal of life sustaining procedures unless absence of actual notice of revocation is result of negligence of health care provider, physician, or other person. Failure to transfer is professional misconduct

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
IDAHO 39-4501. et seq. Natural Death Act	Any medical procedure or intervention which utilizes mechanical means to sustain or supplant a vital function serving only to artificially prolong the moment of death and where death is imminent whether or not procedures are utilized; does not include the administration of medication or a medical procedure to alleviate pain	(1) Of sound mind; (2) emancipated minor or 18 yrs. or older; (3) voluntarily made; (4) 2 witnesses must sign; (5) not enforced during course of pregnancy	Revocable at any time by declarant without regard to competence by (1) destruction of the document; (2) by written, signed revocation; (3) by verbal expression of intent to revoke		Physician may withdraw without civil or criminal liability provided the physician makes a good faith effort to assist the patient in transferring before his/her withdrawal	No civil or criminal liability for a physician acting in accordance with the wishes of the patient as expressed by statutory procedure
ILLINOIS 755 ILCS 35/1, et seq. Illinois Living Will Act	Individual may execute document directing that if he is suffering from a terminal condition and no longer able to participate actively in decisions about himself, then death–delaying procedure shall not be utilized for the prolongation of his life. These procedures include any which serve to postpone the moment of death and specifically include, but are not limited to, assisted ventilation, artificial kidney treatment, intravenous feeding/medication, blood transfusions and tube feedings, but does not include procedures providing for patient's comfort care or alleviation of pain	(1) Sound mind and age of majority or status of emancipated person (sample form at 35/3e); (2) signed by declarant or another at declarant's direction; (3) 2 witnesses over 18; (4) not pregnant (or at point where could develop to point of live birth with continued application of death delaying procedures); (5) notify attending physician	Revocable by declarant at any time without regard to mental or physical condition (1) in writing signed and dated by declarant or person acting at his/her direction; (2) by oral expression in presence of witness who signs and dates a written confirmation; (3) by destroying declaration in manner indicating intent to cancel; revocation is effective upon communication to attending physician	Declaration executed in another state in compliance with law of that state or Illinois is valid	Patient is responsible to initiate transfer; if patient not able to initiate transfer then attending physician shall without delay notify person with highest priority who is available, able, and willing to make arrangements for transfer for effectuation of patient's declaration	No physician, health care provider, or health care expert who in good faith and pursuant to reasonable medical standards causes or participates in withholding or withdrawal of death delaying procedure from qualified patient per declaration shall be subject to criminal or civil liability or be found to have committed an act of unprofessional conduct

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
INDIANA §16-36-4-1 et seq. Living Wills and Life Prolonging Procedures Act	Living will declarant may ask that life prolonging procedures that would sustain, restore, or supplant a vital function or that would serve to prolong the dying process not be used in case of terminal diagnosis and incapacity; this does not include any medical procedure or medication necessary to provide comfort care or alleviate pain.	(1) Person of sound mind, 18 yrs. old; (2) voluntary; (3) in writing; (4) dated; (5) signed in presence of 2 adult witnesses; (6) notice to declarant's attending physician; (7) is presumptive evidence of declarant's intent; (8) not enforced if pregnant (sample form §16-36-4-10). Witnesses must not be related to declarant.	Living will declaration is presumed valid. Revocable at any time by (1) signed and dated in writing; (2) physical destruction by declarant or at declarant's direction; (3) oral expression of revocation		Physician who refuses to comply shall transfer to another physician who will comply unless (1) physician believes declaration is not validly executed and (2) patient is unable to validate declaration. If patient not transferred for above reason, physician should try and ascertain patient's intent and declaration's validity from persons listed in §16-36-4-13 (g)(1-7).	Act of withdrawing or withholding life-prolonging procedures for qualified patient is lawful, and physician is not subject to criminal or civil liability or unprofessional conduct if done in good faith and in accordance with reasonable medical standards. Violation of any provisions of act subjects physician to disciplinary sanctions by medical licensing board.

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
IOWA 144A.2 Life-Sustaining Procedures Act	Declarant may declare desire to not have life-sustaining procedures employed to prolong life; life sustaining procedures are those that utilize mechanical or artificial means to sustain, restore, or supplant a spontaneous vital function and/or when applied to a patient in a terminal condition would only serve to prolong the dying process, does not include provision of nutrition or hydration except when required parenterally or though intubation or the administration of medication or performance of medical procedures which provide comfort care or alleviate pain; declaration shall not be in effect when declarant is pregnant as long as fetus can develop to point of live birth	(1) Declarant competent adult; (2) signed in presence of 2 witnesses and in the presence of each other; (3) physician may presume declaration is valid; (4) actual notice of declaration to attending physician; (5) declaration given effect when declarant's condition is terminal and he is unable to make treatment decisions. (sample form 144A.3(5)) At least one witness must not be related to declarant.	Revocable at any time in any manner that declarant can communicate intent, without regard to mental or physical condition. Physician shall make revocation part of medical records	Similar document executed in another state in compliance with the laws of that state is valid and enforceable in Iowa, to the extent the document is consistent with Iowa law.	Physician shall take reasonable steps to transfer patient to another physician or facility	Individual or health care provider is not liable civilly or criminally or guilty of unprofessional conduct for complying in good faith with provisions in declaration indicating withholding or withdrawal of life-sustaining procedures.

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
KANSAS 65-28, 101 et seq. Natural Death Act	Any medical procedure or intervention which would serve only to prolong the dying process and where death will occur whether or not such procedure is utilized. Does not include medication or any medical procedures necessary to alleviate pain or provide comfort care Declaration not in effect during declarant's pregnancy.	(1) Any adult; (2) in writing; (3) signed by declarant; (4) dated; (5) in presence of 2 or more adult witnesses; (6) no effect during course of pregnancy; (7) responsibility of declarant to notify attending physician; (8) substantially same form as 65-28, 103(c). No witness can be related to declarant.	Revocable at any time by declarant by (1) destruction of document; (2) written revocation signed and dated by principal; (3) verbal expression in presence of adult witnesses who signs and dates a written confirmation. Effective upon receipt by physician. Desires of patient at all times supersede the declaration		Physician shall effect the transfer—failure to do so constitutes unprofession al conduct	No criminal, civil, or professional liability for acting in good faith and pursuant to reasonable medical standards when acting pursuant to a declaration
KENTUCKY 311.621, et seq. Kentucky Living Will Directive Act	Any medical procedure, treatment, or intervention which utilizes mechanical or other artificial means to sustain prolong, restore, or supplant a spontaneous vital function or when administered would only prolong dying process. Does not include medication or procedure to alleviate pain.	(1) Adult with decisional capacity; (2) in writing; (3) dated; (4) either witnessed by 2 or more adults in presence of grantor and in presence of each other or acknowledged before notary; (5) in substantially the same form as §311.625(1). No witness can be related to grantor.	Revocable by (1) written declaration signed and dated by declarant; (2) oral statement of intent to revoke in presence of 2 adults, one of which is a health care provider; (3) destruction of declaration with intent to revoke; (4) effective immediately for attending physician once revocation received; (5) oral statement by grantor with decisional capacity to revoke overrides previous written directive	Directives made outside the provisions of this act does not restrict health care providers from following such directives if they are consistent with accepted medical practice.	Physician must immediately inform patient and family or guardian and shall not impede transfer to complying physician or health care facility; patient's medical records and information shall be supplied to receiving physician or facility	Not subject to criminal prosecution or civil liability or deemed to have engaged in unprofessional conduct as a result of withholding or withdrawing life prolonging treatment in accordance with directive unless shown by preponderance of evidence that there was bad faith

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
LOUISIANA 40:1299.58.1, et seq. Declarations Concerning Life-Sustaining Procedures	Any medical procedure or intervention, including but not limited to invasive administration of nutrition and hydration, which would serve only to prolong the dying process for a person diagnosed as having a terminal and irreversible condition. Does not include any measure necessary for comfort care	(1) Any adult; (2) written declaration; (3) signed by declarant; (4) in presence of 2 adult witnesses; (5) oral or nonverbal declaration may be made in presence of 2 adult witnesses by any nonwritten means of communication at any time subsequent to the diagnosis of a terminal and irreversible condition (sample form §1299.58.3(c))	Revocable at any time by declarant without regard to mental state or competency by (1) destruction of document; (2) written revocation signed and dated by declarant; (3) oral or nonverbal expression by the declarant of the intent to revoke. Effective upon communication to physician	Declaration properly executed in and under the laws of another state is deemed to be validly executed	Physician shall make a reasonable effort to transfer the patient to another physician	Any health care facility, physician, or other person acting under the direction of a physician shall not be civilly, criminally, or professionally liable for withholding life-sustaining procedures in accordance with the provisions of this chapter
MAINE 18-A§§5-801, et seq. Uniform Health-Care Decision Act.	Any medical procedure or intervention administered only to prolong process of dying. May include artificially administered nutrition and hydration	(1) In writing and signed of sound mind and over 18; (2) signed by declarant or another at his direction; (3) witnessed by 2 people; (4) communicated to attending physician; (5) effective upon determination that principal lacks capacity (6) physician records terms of declaration and determination of terminal condition	Revocable at any time and in any manner without regard to declarant's mental or physical condition. Revocation effective upon communication to attending physician or health care provider by declarant or witness to revocation	Declaration executed in another state in compliance with laws of that state and Maine is valid	Attending physician or other health care provider who is unwilling shall take all reasonable steps as promptly as practicable to transfer to another physician willing to comply and provide continuing care until transfer is effected. Willful failure to transfer is Class E crime	Physician or other health care provider whose action is in accord with reasonable medical standards and in good faith is not subject to criminal or civil liability or discipline for unprofessional conduct

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
MARYLAND HG §5-601, et seq. Health Care Decisions Act	Any medical procedure, treatment, or intervention which uses mechanical or other artificial means to maintain, restore a spontaneous vital function or of such a nature as to afford patient no reasonable expectation of recovery from a terminal condition, persistent vegetative state, or end-stage condition; includes artificially administered hydration, nutrition, and CPR. Does not include medication or procedure necessary to alleviate pain or provide comfort care; may include an anatomical gift directive	(1) Voluntary; (2) dated and in writing; (3) signed by declarant or at express direction of declarant; (4) subscribed by 2 witnesses; (5) effective when attending physician and second physician certify in writing that patient is incapable of making an informed decision on basis of physical examination within 2 hrs. of certification (if patient is unconscious, 2nd physician not required); (6) oral directives must be made in presence of attending physician and one witness; physician must sign and date documentation in patient's medical record. (suggested forms §5-603)	Revocable at any time by (1) signed and dated in writing; (2) oral statement to health care practitioner; (3) execution of subsequent directive; (4) destruction of directive.	Declaration executed out-of-state by nonresident is effective if declaration is in compliance with the laws of Maryland or the laws of the state where executed (to the extent permitted by the laws of Maryland)	Attending physician shall make every reasonable effort to transfer declarant to another health care provider; assist in transfer; and pending transfer, comply with competent individual or health care agent/surrogate for person incapable of making a decision if failure to comply would likely result in death of individual.	Any health care provider who withholds or withdraws health care or life-sustaining procedures in accordance with this subtitle and in good faith, is not subject to civil or criminal liability and may not be found to have committed professional misconduct
MASSACHUSETTS No statutory provisions (But see Health Care Proxies Chap. 201D et seq.)
MICHIGAN No statutory provisions (But see Uniform Durable Power of Attorney Act §700.496)

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
MINNESOTA 145B.01, et seq. Living Will Act; 145C.01 Health Care Directive	Decisions on whether to administer, withhold, or withdraw medical treatment, services, or procedures to maintain, diagnose, or treat an individual's physical condition when the individual is in a terminal condition. Decisions must be based on reasonable medical practice including (1) continuation of appropriate care to maintain comfort, hygiene, human dignity, and to alleviate pain; (2) oral administration of food and water to a patient who accepts it, except for clearly documented medical reasons	(1) Competent adult; (2) signed by declarant; (3) signed by 2 witnesses or notary public; (4) must state preference regarding artificial administration of nutrition and hydration or give decision to proxy; (5) must be in substantially the statutory form of §145B.04; (6) operative when delivered to physician or health care provider; (7) not given effect if patient is pregnant and it is possible that fetus could develop to live birth with continued treatment	Revocable at any time in any manner in whole or in part by declarant without regard to declarant's physical or mental condition. Effective upon communication to physician. Divorce revokes any designation of the former spouse as a proxy to make health care decisions	Effective when executed in another state if it substantially complies with Minnesota law	Physician must notify competent declarant of unwillingness but has no duty to transfer. If physician received living will from competent patient and did not notify declarant of unwillingness to comply and declarant subsequently becomes incompetent, physician must take all reasonable steps to transfer to complying physician	Physician acting in good faith and in accordance with applicable standards of care is immune from criminal prosecution, civil liability, or professional disciplinary action
MISSISSIPPI 41-41-201, et seq. Uniform Health-Care Decisions Act	May authorize the withdrawal of life-sustaining mechanisms defined as cessation of use of extraordinary techniques and applications including mechanical devises which prolong life through artificial means	(1) Adult or emancipated minor; (2) in writing; (3) dated; (4) signed by principal; (5) signed by 2 adult witnesses, at least one of whom is not related to principal; (6) acknowledged by notary public.	Revocable at any time in any manner that communicates an intent to revoke. Designation of agent revoked only by signed writing or by personally informing physician.		Physician must promptly inform patient; provide continuing care until transfer can be effectuated; make all reasonable efforts to assist in transfer.	Physician acting in good faith and in accordance with provisions of this Act, who causes withdrawal of life-sustaining mechanisms is not guilty of a criminal offense, or civil or professional liability

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
MISSOURI 459.010, et seq. Declaration; Life Support	Any medical procedure or intervention which would serve only to prolong artificially the dying process where death will occur within a short time whether or not such procedure or intervention is utilized. Does not include medication or procedure to provide comfort care or alleviate pain or any procedure to provide nutrition or hydration	(1) Competent person; (2) in writing; (3) signed by declarant; (4) dated; (5) if not wholly in declarant's handwriting, signed in presence of 2 adult witnesses (sample form §459.015(3)); (6) operative only when declarant's condition is determined to be terminal or declarant is unable to make treatment decisions; (7) declaration shall have no effect during course of declarant's pregnancy	Revocable at any time in any manner declarant is able to communicate intent to revoke, without regard for mental or physical condition. Directions of declarant shall at all times supersede declaration		Physician must take all reasonable steps to effect the transfer of a declarant	No criminal, civil, or professional liability for acting in good faith pursuant to usual and customary medical standards who withholds or withdraws death-prolonging procedures from patient pursuant to a declaration

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
MONTANA 50-9-101 et seq. Rights of the Terminally Ill Act	Withholding or withdrawal of life-sustaining treatment, defined as any medical procedure or intervention that will serve only to prolong the dying process. Qualified patient may designate another individual to make decisions governing withholding or withdrawal of life-sustaining treatment. Life-sustaining procedures may not be withdrawn when qualified patient is known to be pregnant and when it is likely fetus will result in live birth	(1) 18 years or more and of sound mind; (2) signed by declarant or another at declarant's direction; (3) witnessed by 2 individuals; (4) communicated to physician and made part of patient's medical record; (5) declared to be terminal and no longer able to make decisions regarding life-sustaining treatment; (6) absent contrary actual notice, physician or health care provider may presume that declaration is valid (sample form §50-9-103)	Revocable at any time in any manner without regard to physical or mental condition. Effective upon communication to attending physician or health care provider. Health care provider or emergency medical services personnel in receipt of such communication shall act upon revocation an communicate it to attending physician at earliest opportunity. Revocation shall become part of declarant's medical record	Declaration made in another state in compliance with that state's laws executed in a substantially similar manner to laws of Montana is effective	Attending physician or health care provider who is unable or unwilling to comply shall take all reasonable steps as promptly as practicable to transfer to another who is willing	Attending physician or health care provider not subject to civil or criminal liability or guilty of unprofessional conduct as long as acting in accordance with reasonable medical standards and in good faith

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NEBRASKA 20-401, et seq. Rights of the Terminally Ill Act	Any medical procedure or intervention that will serve only to prolong the process of dying or maintain the patient in a persistent vegetative act, meaning that to a reasonable degree of medical certainty one has a total and irreversible loss of consciousness and capacity for cognitive interaction with the environment with no reasonable hope of improvement. Does not affect physician's responsibility to provide treatment, including nutrition and hydration for patient's comfort care or alleviation of pain. Life-sustaining treatment shall be provided if declarant is pregnant and fetus is likely to develop to the point of live birth with continued application of life-sustaining treatment	(1) Adult of sound mind; (2) signed by declarant or another at declarant's direction; (3) witnessed by 2 adults or notary public (adult is one who is over 19 yrs. or is or has been married); (4) communicated to attending physician; (5) patient in terminal condition, persistent vegetative state, or unable to make decisions regarding administration of life-sustaining treatment (sample form §20-404)	Revocable at any time in any manner without regard to declarant's mental or physical condition effective upon communication to physician or other health care provider. Revocation shall become part of declarant's medical record.	Declaration executed in another state in compliance with that state or Nebraska is valid	Physician shall take all prompt and reasonable steps to transfer to a willing physician	Not subject to civil, criminal, or professional discipline in the absence of knowledge of revocation or whose action under this Act is in accord with reasonable medical standards. Unjustifiable violation of patient's directions shall be a civil cause of action maintainable by patient or patient's next officer

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NEVADA 449.535, et seq. Uniform Act on Rights of the Terminally Ill	Any medical procedure which utilizes mechanical or other artificial methods to sustain, restore, or supplant a vital function; does not include medication or procedures necessary to alleviate pain. Artificial nutrition and hydration by way of gastro-intestinal tract is considered medical procedure or life sustaining treatment and must be withheld unless different desire is expressed in writing or agent has authority to withhold consent.	(1) 18 yrs. or older; (2) may designate another to make decisions governing withholding or withdrawing; (3) signed by declarant or another at declarant's direction; (4) 2 witnesses; (5) sample form §449-610 and 449-613; (6) not operative if patient is known to be pregnant and live birth is probable (7) declaration part of medical record	Revocable at any time and in any manner. Effective upon communication to the attending physician or other provider of health care	Declaration executed in another state in compliance with the law of that state or of this state is valid	Physician shall take all reasonable steps as promptly as possible to transfer care of declarant to another physician	Not subject to civil, criminal liability or professional discipline if acted in good faith and in accordance with reasonable medical standards. No liability for failure to follow patient's directions; physician may consider "other factors" in determining whether the circumstances warrant following the directions

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NEW HAMPSHIRE 137-H:1 et seq. Living Wills	Qualified patient may instruct physician not to use life-sustaining procedures in the event the person is in a terminal condition or is permanently unconscious. "Life-sustaining procedures" means any medical procedure or intervention which utilizes mechanical or artificial means to sustain, restore, or supplant a vital function which would only serve to artificially postpone the moment of death where in the written judgement of the attending and consulting physician, the patient is in a terminal condition or permanently unconscious; does not include medication, sustenance, or performance of any medical procedure to alleviate pain or provide comfort. There must be a clear expression of one's intent to withdraw or withhold artificial nutrition and hydration.	(1) Person of sound mind, 18 yrs. or older; (2) document signed voluntarily by declarant (3) 2 subscribing witnesses not a spouse or heir at law; (4) upon request, physician shall made document part of medical record; (5) effective if person is permanently incapable of participating in decisions about his care; (6) suggested form §137-H:3; (7) not permitted when physician has knowledge that patient is pregnant	Revocable by (1) destroying document; (2) oral or written revocation before 2 witnesses. Revocation effective upon communication to attending physician	Documents executed in another state are enforceable if in compliance with the law of that state or jurisdiction; foreign living wills are restricted by, and must be in compliance with laws and requirements of New Hampshire	Physician unwilling or unable to comply shall notify and inform the patient and/or patient's family. Patient or his family may then request transfer to another physician. Physician shall make necessary arrangements without delay to effect transfer to chosen physician	Physician or health care professional is immune from civil or criminal liability for good faith actions in keeping with reasonable medical standards pursuant to the living will and in accordance with New Hampshire Law

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NEW JERSEY 26:2H-53, et seq. Advanced Directives for Health Care	Decisions to accept or refuse any treatment, service, or procedure used to diagnose, treat, or care for a patient's physical or mental condition including life-sustaining treatment; includes decisions to accept or refuse services of a particular physician or health care provider or a transfer of care; or use of any medical device or procedure, artificially provided fluids and nutrition drugs, surgery, or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function and thereby increase the expected life span of a patient; does not include providing comfort care or to alleviate pain.	(1) Competent; (2) adult; (3) signed; (4) dated; (5) in presence of 2 witnesses who shall attest that declarant is of sound mind and free of duress and undue influence or in front of a notary public, attorney, or another person authorized to administer oaths. May be supplemented by video or audio tape recording; (6) directive implemented when determination of lack of decision-making capacity is documented and confirmed by physicians	Revocable by oral or written notification or execution of subsequent directive. Divorce revokes former spouse's designation as the health care representative. Patient's clearly expressed wishes take precedent over any patient's decision or instruction directive	Effective if executed in compliance with New Jersey law or the laws of that state. Effective if executed in a foreign country in compliance with that country's laws or the laws of New Jersey and is not contrary to the public policy of New Jersey	Physician should act as soon as practicable to effect an appropriate, respectful, and timely transfer of care and to assure that patient is not abandoned or treated disrespectfully	No civil, criminal, or professional liability for any physician acting in good faith and pursuant to this act
NEW MEXICO 24-7A-1, et seq. Uniform Health-Care Decisions Act	Any medical treatment or procedure without which the individual is likely to die within a short time	(1) Of sound mind; (2) age of majority; (3) written or oral; (4) dated; (5) 2 adult witnesses; (6) effective when patient no longer able to make own health-care decisions.	Revocable at any time in any way that communicates an intent to revoke.	Document Uniformly applied and construed among states enacting Uniform Health-Care Decisions Act.	Physician must take appropriate steps to transfer the patient to another qualified physician and provide continuing care to patient until transfer.	No civil or criminal liability or professional discipline for acting pursuant to statute in good faith

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NEW YORK No statutory provisions (But see Health Care Agents and Proxies Public Health Art.29-C §2980 et seq.)
NORTH CAROLINA 90-320, et seq. Right to Natural Death	Declarant may instruct attending physicians to withhold extraordinary means to keep declarant alive whose condition is either terminal and incurable or who is in a persistent vegetative state as confirmed in writing by second physician which would only serve to postpone artificially the moment of death by sustaining, restoring, or supplanting a vital function	(1) Signed; (2) in the presence of 2 witnesses who believe declarant is of sound mind; (3) dated; (4) notarized or proved before a clerk; (5) specific form §90-321(a)	Revocable in any manner by which declarant is able to communicate his intent to revoke without regard for mental or physical state—effective upon communication to physician			Withholding or discontinuing of extraordinary means shall not be considered cause of death for civil or criminal purposes. These provisions may be asserted as a defense to any civil or criminal suits or charges filed against a health care provider

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
NORTH DAKOTA 23-06.4-01, et seq. Uniform Rights of Terminally Ill Act	Any medical procedure, treatment, or intervention that serves only to prolong the process of dying. Does not include the provision of the appropriate nutrition and hydration (presumed to be in the best interests of the patient) or any medical procedure necessary to provide comfort care or to alleviate pain or procedures performed in emergency, pre-hospital situations; medical treatment must be provided to a pregnant patient—unless to a reasonable degree of certainty, such treatment won't maintain patient to ensure live birth or is physically harmful	(1) Sound mind; (2) 18 yrs.; (3) signed by declarant; (4) witnessed by 2 persons; (5) substantially same form as §23-06.4-03 (3) (may add specific directives)	Revocable at any time in any manner as long as declarant is competent, including (1) by signed, dated writing; (2) destruction of document; (3) oral expression of intent to revoke. Effective upon communication to physician or other health care provider	Effective if executed in another state by a resident of that state in compliance with the laws of that state or the laws of North Dakota	Physician must take all reasonable steps to transfer patient as promptly as practical to physician willing to comply with statute	No civil, criminal, or professional liability for actions authorized by statute unless done in a grossly negligent manner
OHIO 2133.01, et seq. Modified Uniform Rights of the Terminally Ill Act	Any medical procedure, treatment, intervention, or other measure that will serve principally to prolong the process of dying. Declarant may authorize withholding hydration and nutrition; cannot withdraw or withhold life-sustaining treatment from pregnant patient, unless it is believed to a reasonable degree of certainty, that the fetus would not be born alive.	(1) Adult; (2) of sound mind; (3) signed by declarant; (4) dated; (5) in presence of 2 witnesses or a notary public who attests that principal is of sound mind and free from duress	Revocable at any time and in any manner; effective when expressed and communicated to a witness or physician	Effective if executed in another state in compliance with that law or in substantial compliance with Ohio law	Physician may not prevent or unreasonably delay a transfer	No civil, criminal, or professional liability for physician acting in good faith within the scope of their authority

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
OKLAHOMA Tit. 63 §3101.1 et seq.; Rights of the Terminally Ill or Persistently Unconscious Act	Any medical procedure or intervention that will serve only to prolong the dying process including artificial administration of nutrition and hydration but only if declarant has specifically authorized its withdrawal. Does not include treatment to alleviate pain or the normal consumption of food and water	(1) 18 yrs.; (2) of sound mind; (3) signed by declarant; (4) witnessed by 2 adults; (5) in substantially the same form as §3103.4(B); (6) operative when communicated to attending physician and when declarant can no longer make decisions regarding the administration of life-sustaining treatment; not operative during course of pregnancy	Revocable in whole or in part in any manner at any time without regard to declarant's mental or physical condition. Effective upon communication to physician	Effective if complies with Oklahoma law or in compliance with law of that state so long as it does not exceed authorizations allowed under Oklahoma law	Physician shall take all reasonable steps to arrange for care by another physician; must comply with decision until transfer.	No civil, criminal, or professional liability for carrying out the advance directive pursuant to statute in good faith and in accord with reasonable medical standards
OREGON 127.505, et seq. Advance Directives for Health Care	Life-sustaining acts means mechanical or other artificial means to sustain, restore, or supplant a vital function that is used to maintain life of a person suffering from a terminal condition and serves only to prolong artificially the moment of death; does not include procedures to sustain patient cleanliness and comfort	(1) In writing; (2) signed by two witnesses who make written declaration; (3) mandatory statutory form §127.531 ORS; (4) at least one witness must not be related to declarant	Principal may revoke (1) in any manner by which s/he is able to communicate to health care provider or attorney-in-fact, intent to revoke; (2) by execution of subsequent durable power of attorney; (3) upon divorce if spouse is agent	Valid subject to laws of Oregon if executed in compliance with the laws of the state where principal is located or resides or with the laws of the state of Oregon.	Physician shall notify any representative or discharge patient (without abandoning) or make a reasonable effort to locate and transfer to a willing physician.	No liability, if in good faith has acted on fully executed directive, for criminal or civil liability or professional disciplinary action

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
PENNSYLVANIA 20§5401 et seq. Advanced Directive for Health Care Act	Any medical procedure or intervention that serves only to prolong the process of dying or maintain the patient in a state of permanent unconsciousness; includes artificially or invasively administered nutrition and hydration if specifically provided for in declaration. Does not apply to emergency medical services.	(1) sound mind; (2) 18 yrs. or graduated from high school or married; (3) signed by declarant; (4) 2 adult witnesses; (5) suggested form 20§5404(b); (6) operative when declarant determined to be incompetent by attending physician as certified in writing; (7) not operative during pregnancy unless it will not maintain woman so as to permit live birth	Revoked at any time in any manner without regard to declarant's mental or physical condition. Effective upon communication to physician.		Unwilling physician must inform declarant, surrogate, or family, and make every reasonable effort to assist in the transfer of declarant to complying physician	No civil, criminal, or professional liability in following wishes of declarant pursuant to declaration executed according to statute.
RHODE ISLAND 23-4.11-1, et seq. Rights of Terminally Ill Act	Any medical procedure or intervention serving only to prolong the dying process. Does not include anything necessary to alleviate pain or provide comfort and care; must wear DNR bracelet in order to effectuate "do not resuscitate" order.	(1) 18 yrs.; (2) signed; (3) in presence of 2 witnesses (suggested form §23-4.11-3(a)); (4) given no force or effect as long as live birth is probable for pregnant patient; neither witness related to declarant.	Revocable at any time in any manner by which declarant is able to communicate the intent to revoke without regard to physical or mental condition. Only effective upon communication to physician by declarant or one witnessing the revocation	Declaration executed in another state in compliance with the laws of that state is valid.	Physician shall make necessary arrangements to effect a transfer	No civil, criminal, or professional liability for acting in accordance with requirements of the statute and in accordance with reasonable medical standards

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
SOUTH CAROLINA 44-77-10, et seq. Death with Dignity Act	Medical procedures or intervention serving only to prolong the dying process; does not include treatment for comfort care or pain alleviation; declarant should indicate whether nutrition and hydration through surgically implanted tubes is desired; if declarant fails to do so, nutrition and hydration necessary for comfort care and pain alleviation will be provided.	(1) Declaration must set out intent for no life-sustaining procedures; (2) signed; (3) dated; (4) in presence of officer authorized to administer oaths; (5) presence of 2 witnesses; (6) substantially same as §44-77-50; (7) not effective during course of declarant's pregnancy; (8) terminal condition must be certified by 2 examining physicians (permanent unconsciousness must be at least for 90 days; or with high degree of medical certainty and must be given active treatment for at least 6 hrs. following diagnosis before physician can give effect to declaration).	(1) Destruction of document when communicated to physician; (2) written revocation signed and dated upon communication to physician; oral expression of intent to revoke when communicated to physician; (3) communication of oral revocation may be made by someone present when revocation made, if communicated within reasonable time and declarant is physically or mentally able to confirm or by designee if declarant is incompetent; (4) execution of subsequent declaration	For patients in terminal condition, document with same intent as this chapter and in compliance with the laws of that state is effective.	Physician must make a reasonable effort to locate a physician who will effectuate patient's declaration and has a duty to transfer patient to such physician	No criminal or civil liability for acting in good faith and in accordance with the standards of reasonable medical care pursuant to the statute

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
SOUTH DAKOTA 34-12D-1, et seq. Living Wills	Any medical procedure or intervention that will serve only to postpone death or maintain person in state of permanent unconsciousness. Does not include comfort care, hygiene and human dignity, oral administration of food and water, or medical procedure to alleviate pain	(1) Competent adult; (2) signed by declarant; (3) witnessed by 2 adults; (4) may be in presence of notary public (suggested form §34-12D.3); (5) not operative for pregnant woman unless live birth unlikely to a reasonable degree of medical certainty	Revocable at any time in any manner without regard to declarant's physical or mental condition. Effective upon communication to physician or other health care provider	Document is valid if it meets execution requirements of place where executed, place where declarant was a resident, or requirements of the state of South Dakota	Unwilling physician must make a reasonable effort to locate and transfer a patient to a physician who will honor the declaration; must continue treatment or care until transfer is effectuated	No civil, criminal, or professional liability for giving effect to a declaration
TENNESSEE 32-11-101, et seq. Right to Natural Death Act	Any procedure, treatment to diagnose, assess, or treat a disease, illness, or injury. Includes surgery, drugs, transfusions, mechanical ventilation, dialysis, CPR, artificial nourishment, hydration or other nutrients, radiation. Death by starvation or dehydration allowed only if specifically directed by using statutory phrase.	(1) Competent adult; (2) signed; (3) in presence of 2 witnesses; (4) substantially in form of §32-11-105. Witnesses must not be related to declarant.	Revocable at any time by declarant regardless of mental state if effectively communicated to the physician by written revocation dated and signed or oral statement made to physician	Effective if in compliance with Tennessee law or the law of the state of declarant's residence	Unwilling physician must make every reasonable effort to assist in a transfer.	No civil, criminal, or professional liability if acting in accord with reasonable medical standards

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
TEXAS Health & Safety Code §166.031, et seq. Natural Death Act	Medical procedure or intervention that uses mechanical or other artificial means to sustain, restore, or supplant a vital function and artificially postpone the moment of death of a patient in terminal condition whose death is imminent within a relatively short time without the procedure. Does not include administration of medication or performance of procedure to provide comfort or alleviate pain. May designate a person to make treatment decisions in the event declarant becomes comatose or otherwise incompetent.	(1) Competent adult; (2) 2 witnesses; (3) may be oral with 2 witnesses and attending physician; (4) directive shall become a part of medical record of declarant (if oral, witnesses must sign medical records); (5) not operative for pregnant patients	Revocable at any time without regard to declarant's mental state or competency. May be revoked by declarant or someone in presence destroying document; by signed and dated written revocation; orally stating intent to revoke. Effective when delivered or mailed to attending physician, or when physician notified of oral revocation. Directive effective until revoked. Desire of qualified competent patient supersedes directive		Unwilling physician must make reasonable effort to transfer patient to another physician	Immune from effects of revocation if not adequately notified. No criminal or civil liability for failing to effectuate a directive if there is no knowledge of it. By complying with legal directive, one does not commit act of criminally aiding suicide. No civil, criminal, or professional liability for acting in accordance with this Act unless negligent.
UTAH 75-2-1101; Personal Choice and Living Will Act	Any medical procedure or intervention that would serve only to prolong the dying process including artificial nutrition and hydration unless declaration specifically excludes; does not include medication, sustenance, or any procedure to alleviate pain or provide comfort care. Separate procedure for do not resuscitate directive	(1) 18 yrs.; (2) in writing; (3) signed by declarant or at his directive; (4) dated; (5) signed in presence of 2 or more adult witnesses; (6) substantially same form as §75-2-1104(4); (7) no force during course of declarant's pregnancy	Current wishes of declarant take precedent over any directive. Revocable at any time by signed revocation or destruction of document or oral expression of intent to revoke in presence of adult witness. Effective on receipt by physician	Similar instrument executed in another state is presumed to comply with Utah law and may be relied upon in good faith	Unwilling physician required to transfer patient promptly	No civil, criminal, or professional liability for good faith compliance with a directive

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
VERMONT Tit. 18 §§5251, et seq. Terminal Care Document	Any medical procedure or intervention utilizing mechanical or other artificial means to sustain, restore, supplant a vital function serving only to postpone the moment of death and where patient is in a terminal state according to judgment of physician	(1) 18 yrs.; (2) of sound mind; (3) in presence of 2 or more witnesses; (4) suggested form: §5253	Revocable only orally in presence of 2 or more witnesses or by destroying the document		Unwilling physician must actively assist in selecting another physician willing to honor patient's directive	No civil or criminal liability for physician acting pursuant to the terminal care document
VIRGINIA 54.1-2981, et seq. Health Care Decision Act	Any medical procedure, treatment, intervention, utilizing mechanical or other artificial means to sustain, restore, or supplant a vital function, or is of a nature to afford a patient no reasonable expectation of recovery from a terminal condition, and when applied to a patient in terminal condition, would serve only to prolong the dying process. Includes artificially administered hydration and nutrition and CPR by emergency medical services personnel but does not include any medication or procedure to alleviate pain or provide comfort care.	(1) Competent adult; (2) written advance directive; (3) signed in presence of 2 subscribing witnesses; (4) oral declaration in presence of physician and 2 witnesses for those in terminal condition; (5) responsibility of declarant to provide notification of advanced directive to attending physician (suggested form §54.1-2984)	Revocable at any time by (1) signed, dated writing; (2) physical cancellation or destruction of declaration; (3) oral expression of intent to revoke. Effective upon communication to attending physician	Directive executed in another state valid if in compliance with Virginia law or law of state where executed. Such directives shall be construed in accordance with Virginia laws.	If physician thinks treatment is medically or ethically inappropriate or contrary to terms of advanced directive, unwilling physician shall make reasonable effort to transfer patient to another physician.	No civil, criminal, or professional liability if acting in good faith.

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
WASHINGTON 70.122.010, et seq. Natural Death Act	Withdrawal or withholding of any medical or surgical intervention which utilizes mechanical or other artificial means including artificially provided nutrition and hydration to sustain, restore, or supplant a vital function which would serve only to artificially prolong life. Shall not include administration of medication to alleviate pain	(1) Any adult; (2) signed by declarant; (3) presence of 2 witnesses; (4) suggested form: §70.122.030. Witnesses must not be related to declarer.	Revocable at any time without regard to declarer's mental state or competency by defacing or destroying document; written revocation signed and dated and communicated to attending physician; oral revocation to physician by declarant or one acting on behalf of declarant	Valid to the extent permitted by Washington law and federal constitution law	Attending physician must inform patient or agent of any policy that would preclude the honoring of patient's directive. If patient chooses to retain that physician, a written plan is filed showing physician's intended actions should directive become operative.	No civil, criminal, or professional liability if acting in good faith unless otherwise negligent
WEST VIRGINIA 16-30-1, et seq. West Virginia Health Care Decisions Act	Any medical procedure or intervention which should serve solely to artificially prolong the dying process or maintain the person in a persistent vegetative state; does not include medication or other medical procedure necessary for comfort or to alleviate pain	(1) 18 yrs.; (2) in writing; (3) executed by declarant or at his direction; (4) dated; (5) in presence of 2 witnesses; (6) in front of notary public; (7) suggested form: §16-30-3(e)	Revocable at any time without regard to declarant's mental state by destruction of document, written revocation effective on delivery or verbal expression in presence of a witness; desires of capable declarant always supersede effect-of-living will	Valid in West Virginia if executed in compliance with West Virginia law or the law of state where executed and expressly provides for withholding or withdrawal of life-prolonging intervention or termination of life-sustaining procedure	Unwilling physician must effect a transfer to physician willing to honor the living will	No criminal or civil liability if acting in good faith and pursuant to reasonable medical standards

Table 37c: Right to Die: Living Wills—Continued

State/Code Section	Specific Powers, Life-Prolonging Acts	Operative Facts	Revocation/Duration	Reciprocity	Transfer of Patient if Physician Unwilling	Immunity for Attending Physician
WISCONSIN 154.01, et seq. Natural Death	Any medical procedure or intervention that would serve to prolong the dying process but not avert death; includes assistance in respiration, artificial maintenance of blood pressure and heart rate, blood transfusion, kidney dialysis, and similar procedures but does not include pain alleviation or provision of nutrition or hydration	(1) 18 yrs. and of sound mind; (2) signed; (3) in presence of 2 witnesses; (4) notify physician; (5) form: §154.03; (6) no effect during pregnancy; (7) may file with register in probate. Witnesses must not be related to declarant.	Revocable at any time by destruction of document, written revocation signed and dated, or verbal expression of revocation effective upon notifying physician. Desires of qualified patient supersede declaration at all times	Declarations made in other states valid to the extent consistent with the laws of this state	Must make good faith effort to transfer	No criminal, civil, or professional liability when acting in good faith
WYOMING 35-22-101 et seq. Living Will	Any medical procedure, intervention, or nourishment by artificial means which would serve only to prolong the dying process of a qualified patient; does not include medication or procedure necessary for comfort care or alleviation of pain	(1) Adult; (2) in writing; (3) signed and dated; (4) in presence of 2 or more adult witnesses; (5) substantially same form as §35-22-102(d); (6) no effect during course of qualified patient's pregnancy; (7) terminal condition must be certified in writing by 2 physicians. Witnesses must not be related to declarant.	Revocable by destruction of document, written revocation, verbal expression of intent to revoke in presence of adult witness. Patient's immediate desires at all times supersede the document		Unwilling physician must attempt to effect transfer of patient	No criminal or civil liability for physician acting in good faith and pursuant to reasonable medical standards