An advance health care directive is how you keep a say in your medical care even if you can no longer speak for yourself. In Pennsylvania these documents are governed by 20 Pa.C.S. Chapter 54, and they come in two parts that work together: a living will and a health care power of attorney. Putting them in place is one of the kindest things you can do for your family, because it spares them from guessing what you would have wanted in a crisis. This guide explains what each part does and how to make one valid.
Two parts of a Pennsylvania advance directive
- Living will: your written instructions about life-sustaining treatment if you are permanently unconscious or have an end-stage condition.
- Health care power of attorney: names a health care agent to make medical decisions for you when you cannot.
Many Pennsylvanians sign a single "combined" advance directive that includes both.1
The living will
A living will is a written declaration that states what medical treatment you do or do not want if you reach a point where you cannot express your wishes. Under Pennsylvania law, a living will generally becomes operative only when two conditions are met: your attending physician has a copy, and you have been determined to be incompetent and to have an end-stage medical condition or to be permanently unconscious.2 In other words, it does not control ordinary, recoverable illnesses; it speaks for you only in the gravest situations. In it you can accept or refuse things like cardiac resuscitation, mechanical ventilation, tube feeding, and other life-sustaining measures.
The health care power of attorney
A health care power of attorney is broader and more flexible. It names a person, your health care agent, to make medical decisions on your behalf whenever you are unable to make or communicate them, not only at the very end of life.1 A living will can only anticipate so many scenarios; a trusted agent can respond to the actual situation in real time, ask questions of the doctors, and weigh options you never thought to write down. For that reason, many people consider the health care agent the more important half of the directive. This agent is separate from the agent under your financial power of attorney, which we cover in our guide to the Pennsylvania power of attorney.
Signing and witness requirements
To be valid in Pennsylvania, an advance health care directive must be:2
- In writing and signed and dated by you, the principal (or by another person at your direction and in your presence).
- Witnessed by two individuals, each 18 or older.
A person you name as your health care agent should not serve as a witness. Unlike a financial power of attorney, a Pennsylvania advance directive does not have to be notarized, though notarizing it does no harm and some people do it for extra assurance. Keep the requirements straight: the two documents follow different rules.
Give copies to the people who need them. A living will only becomes operative once your attending physician has a copy, so a directive locked in a drawer cannot help you. Give copies to your health care agent, your primary doctor, and your local hospital, and tell your family it exists and where to find it.
What each document covers, side by side
| Question | Living will | Health care POA |
|---|---|---|
| What it does | States your treatment wishes in writing | Names a person to decide for you |
| When it applies | End-stage condition or permanent unconsciousness | Any time you cannot make or communicate decisions |
| Flexibility | Fixed instructions | Real-time judgment by your agent |
| Must be notarized? | No | No |
Changing or revoking a directive
You can revoke or change an advance directive at any time, regardless of your physical or mental condition, by any clear expression of your intent to revoke it. It is wise to sign a fresh directive after a major life change, such as a divorce, a diagnosis, or the death of the agent you had named, and to collect and destroy older copies so there is no confusion about which one is current.
Completing your plan
An advance directive handles your medical wishes, a financial power of attorney handles your money if you are incapacitated, and a will handles your property after death. Together they form a complete plan. Once your health care documents are in place, put your property wishes on paper too: see our step-by-step guide on how to write a will in Pennsylvania, or build one now with our will form.
Sources
- 1Title 20 Pa.C.S. Chapter 54, Health Care (advance directives), Pennsylvania General Assembly (legis.state.pa.us)
- 220 Pa.C.S. Chapter 54 (living wills and health care powers of attorney), Justia (law.justia.com)
Frequently Asked Questions
What is the difference between a living will and a health care power of attorney? A living will states your written wishes about life-sustaining treatment for end-of-life situations. A health care power of attorney names a person to make medical decisions for you any time you cannot, not only at the very end of life. Many people sign a combined document with both.
Does a Pennsylvania advance directive have to be notarized? No. A Pennsylvania advance health care directive must be signed and dated by you and witnessed by two individuals aged 18 or older. Notarization is optional.
When does a living will take effect in Pennsylvania? Generally only once your attending physician has a copy and you have been determined to be incompetent and to have an end-stage medical condition or to be permanently unconscious.
Can I change my advance directive later? Yes. You can revoke or change it at any time by any clear expression of your intent, regardless of your condition. Sign a fresh one after major life changes and destroy older copies.
About the author
Max Kuch
Max Kuch writes about estate planning, wills and inheritance for Pennsylvania Will Template. He gathers the rules from the Pennsylvania statutes and the leading public data, then explains them in plain, accessible language so anyone can put their wishes in writing.