Pennsylvania Advance Directive and Living Will: Forms, Rules, and How to Complete Yours
Pennsylvania prints its example form directly in the statute. Two adult witnesses, no notary, no registry, and a few quirks worth knowing before you sign.
Pennsylvania has no single mandatory form. The statute supplies a free example: the Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will) at 20 Pa.C.S. § 5471. To be valid, your directive must be dated, signed by you or at your direction, and witnessed by two people 18 or older. No notary is required.
Those rules come from Chapter 54 of Title 20 of the Pennsylvania Consolidated Statutes, rewritten by Act 169 of 2006. Living wills are governed by §§ 5441 to 5447, health care agents and representatives by §§ 5451 to 5465, and the combined example form sits at § 5471. This guide walks through the document in Pennsylvania's own terms, the signing rules, and four quirks of Pennsylvania law that surprise people, including the narrow conditions under which a living will actually takes effect.
In this guide:
Pennsylvania advance directive: the facts at a glance
What an advance directive means in Pennsylvania
How to complete the form, step by step
Who can witness (almost anyone, and why that cuts both ways)
When a living will actually takes effect
Under 18: Pennsylvania's eligibility quirk
Pregnancy and your directive
Living will vs advance directive vs health care power of attorney
What to do after you sign
Frequently asked questions
Pennsylvania advance directive: the facts at a glance
Question | Pennsylvania answer |
|---|---|
Form name | No mandatory form. The statutory example is the Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will) at 20 Pa.C.S. § 5471 |
Statute | 20 Pa.C.S. Chapter 54 (Act 169 of 2006): living wills §§ 5441 to 5447, health care agents and representatives §§ 5451 to 5465, combined form § 5471 |
Witnesses | Two, each 18 or older, for both the living will and the health care power of attorney |
Notary | Not required |
State registry | None. Pennsylvania operates no advance directive registry |
Where to keep it | Original somewhere your family can find it, copies with your health care agent and your doctor. A living will cannot operate until a copy reaches your attending physician |
What an advance directive means in Pennsylvania
In Pennsylvania law, living will is the statutory term for a writing that governs the initiation, continuation, withholding, or withdrawal of life-sustaining treatment. An advance health care directive is the umbrella: the statute defines it as a health care power of attorney, a living will, or a written combination of the two.
That written combination is exactly what the General Assembly placed in the statute at § 5471, under the title Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will). One document, two jobs: it names a health care agent to speak for you when you cannot, and it records your instructions about end-of-life treatment. You are not required to use it. Any writing that satisfies the execution rules in §§ 5442 and 5452 is valid, and hospitals, elder-law firms, and advocacy groups all publish their own Pennsylvania versions. The statutory example has one quiet advantage: nobody can argue that it fails to reflect Pennsylvania law.
If you want to understand how these documents are built before you commit words to paper, our living will template guide walks through each clause in plain English. This page covers what Pennsylvania specifically demands.
How to complete your Pennsylvania advance directive, step by step
Get a form. The example form is printed directly in the statute at 20 Pa.C.S. § 5471, so it is free and authoritative. Hospitals, elder-law attorneys, and Pennsylvania's area agencies on aging distribute their own versions, which are equally valid as long as they meet the signing rules below.
Choose your health care agent. Pick the person who will make medical decisions when you cannot, and name at least one successor in case your first choice is unavailable. More on this choice below.
Work through the treatment instructions. The living will half of the document asks what you want if you are ever in an end-stage medical condition or permanently unconscious: life-sustaining treatment generally, cardiac resuscitation, mechanical ventilation, tube feeding and hydration. Take the choices one at a time and be specific where you can.
Add anything the checkboxes miss. You can write in personal instructions: the values that should guide your agent, treatments you feel strongly about either way, religious considerations, wishes about organ donation. The more context you give, the easier your agent's job becomes at the hardest possible moment.
Date and sign. Sign by signature or mark. If you physically cannot, another individual may sign for you at your direction, with two limits: that person cannot then act as one of your witnesses, and a health care provider who is serving you (or that provider's agent) cannot be the one who signs on your behalf.
Have two adults witness. Two witnesses, each 18 or older, sign for both halves of the document. Pennsylvania's witness rules are unusually relaxed; the next sections explain who qualifies and why you might still want to be choosy.
Skip the notary. Pennsylvania does not require notarization for a living will or a health care power of attorney. Signing at a notary's desk does no harm, and it can smooth recognition if the document is ever presented in a stricter state, but Chapter 54 never asks for it.
Choosing your health care agent
Your agent is the person who carries your wishes into a hospital room when you cannot speak. The right pick is someone who knows you well, can ask doctors hard questions, and will honour your instructions even under pressure from other relatives. Geography helps but matters less than backbone. Name a successor too, and talk to both of them now, while the conversation is easy.
If you name nobody, Pennsylvania does not leave the decision to chance: the statute designates a health care representative for you from a default list of family members, starting with your spouse. That safety net is better than silence, but it hands the role to a position in your family tree rather than to the person you would actually choose, and it invites conflict where relatives disagree. Naming an agent settles the question in advance.
Who can witness, and who cannot
Two witnesses, each at least 18 years old, must sign for both the living will (§ 5442) and the health care power of attorney (§ 5452). The disqualifications are narrow. An individual who signed the document on your behalf may not also witness it. And a health care provider serving you, or that provider's agent, may not be the one who signs the document for you. That is essentially the whole list, which brings us to the first Pennsylvania quirk.
Family, heirs, even your agent can witness: why that cuts both ways
If you have read about living wills in other states, you probably expect a list of banned witnesses: no relatives, no heirs, nobody named in the document. Pennsylvania has no such list. Chapter 54 does not disqualify your spouse, your children, people who stand to inherit from you, or even the very agent the document appoints. People who move here from stricter states find this genuinely surprising.
The permissive rule is convenient. If the moment arrives at a kitchen table, or in a hospital room with only family present, the document you sign is still valid. But convenient is not always wise. If a directive is ever questioned later, witnesses with a stake in your estate hand a challenger material to work with. When you have the luxury of choice, pick two adults with nothing to gain: a neighbour, a colleague, a friend. Save the permissive rule for when it is genuinely needed.
When your living will actually takes effect (and when it does not)
This is the most misunderstood piece of Pennsylvania's law. A living will here is not a general instruction sheet that applies whenever you are seriously unwell. Under Chapter 54 it operates only when three things are all true: a copy has been given to your attending physician, you have been determined to be incompetent, and you have been determined to have an end-stage medical condition or to be permanently unconscious.
Each requirement does real work. The physician condition means a living will locked in a drawer, or sitting in a safe deposit box, is legally dormant no matter how carefully it was signed. Getting a copy to your doctor is not an optional courtesy in Pennsylvania; it is the on switch. The medical conditions mean the document does not govern routine surgery, a treatable illness, or a temporary crisis you are expected to recover from. While you can speak for yourself, you decide. While you are incapacitated but expected to recover, your agent decides under the power of attorney.
That last point is the strongest practical argument for the combined § 5471 form. A health care power of attorney generally covers any decision you cannot make yourself, not only the end of life. A living will alone leaves a wide gap between healthy and dying in which nobody has clear written authority. The combined document closes it.
Under 18? Pennsylvania's eligibility quirk
Most states draw a hard line at 18. Pennsylvania draws the same line, then cuts three doors in it: a person under 18 may execute an advance directive if they have graduated from high school, are married, or are legally emancipated.
In practice this matters for a small but real group: young people living with serious illness, seventeen-year-olds who finished school early, young spouses. If that describes someone in your family, they do not have to wait for a birthday to put their wishes in writing, and the execution rules are the same ones described above.
Pregnancy limits how your directive is followed
Pennsylvania is one of the states whose statute restricts giving effect to a directive to withhold or withdraw life-sustaining treatment while the patient is pregnant. Section 5429 sets out the framework and its exceptions; the restriction is not absolute, but the practical point is simple: if pregnancy is a possibility for you, your directive may not be followed as written during it, whatever the document says.
There is no drafting trick that fully overrides a statute. What you can do is be aware the limit exists, talk it through with your physician and, if it matters to you, an attorney, and still record your wishes in the document. Written wishes inform every decision the law does leave open.
Living will vs advance directive vs health care power of attorney in Pennsylvania
The three terms get used interchangeably in conversation, but Pennsylvania's statute gives each a precise meaning, and the distinctions decide who can act and when.
Living will. Your own written instructions about life-sustaining treatment. It speaks for you directly, but only in the narrow circumstances described above: incompetence plus an end-stage medical condition or permanent unconsciousness, with a copy in your attending physician's hands.
Health care power of attorney. Appoints a person, your health care agent, to make medical decisions whenever you cannot. Broader than the living will, because it covers the whole territory of incapacity, not just the end of life.
Advance health care directive. The umbrella term for either document or a written combination of both. The § 5471 example is the combination, and for most people the combination is the right answer: instructions plus a trusted human to interpret them.
One honest limit is worth naming while you are thinking about all this. An advance directive protects your medical wishes, and it does that job well. It says nothing about your voice, your stories, or the way you think. The form asks whether you would want a ventilator; it never asks what you would say to your granddaughter on her wedding day. Preserving that side of you is a separate act, done while you are well, and it is what a digital legacy app is built for.
What to do after you sign
A signed directive that nobody can find is worth little anywhere, and less in Pennsylvania, where a living will only operates once your attending physician holds a copy. Distribution is the second half of the job.
Give copies to your agent and successor agent. They cannot advocate from memory. Walk them through your choices while you hand it over.
Give a copy to your doctor. Ask that it be added to your medical record. This is the step that arms the living will half of the document.
Give one to your usual hospital or health system. Most Pennsylvania systems will scan it into your patient record so it surfaces at admission.
Tell your family where the original lives. A desk drawer or home file beats a safe deposit box, which may be sealed exactly when the document is needed.
Do not look for a registry. Pennsylvania operates no advance directive registry, so no institution will find your document automatically. Private national registries exist, but nothing in Pennsylvania law requires or consults one. Hand-delivered copies are the system.
Review the document after any big life change: a new diagnosis, a marriage or divorce, the death of an agent, a move between states. If you replace it, collect and destroy the old copies and re-deliver the new one, especially to your physician. And treat the paperwork as the written end of a longer conversation; our advance care planning guide covers the talking part, which is the part families remember.
How your advance directive fits a complete plan
An advance directive covers medical decisions while you are alive. It does not move property, name guardians, or settle your estate; that is your will's job, and if you die without one, Pennsylvania's intestacy rules decide for you. Our guides to probate in Pennsylvania and dying without a will in Pennsylvania cover that side. Your online life needs its own instructions too, from email to photo libraries; our digital will guide for the USA explains what to put in writing and how state law lets an executor act on it.
While you are putting things in order, take stock of what the paperwork cannot hold. The directive protects your choices, and a will moves your property, but neither carries your laugh, your advice, or the stories only you can tell. With Afterlife AI™ you can build a Persona from your memories and voice while you are well, so the people you love keep more than documents. Start free: 50 memories, no card.
Frequently asked questions
Does Pennsylvania require a notary for a living will or advance directive?
No. Neither the living will (20 Pa.C.S. § 5442) nor the health care power of attorney (§ 5452) requires notarization. The document must be dated, signed by you or at your direction, and witnessed by two people who are at least 18. If you spend time in other states, adding a notary can make recognition elsewhere smoother, but Pennsylvania itself does not ask for one.
How many witnesses does a Pennsylvania advance directive need?
Two, and each must be 18 or older. The same rule covers both the living will and the health care power of attorney. If someone signed the document on your behalf because you could not, that person cannot also serve as a witness.
Is a living will the same as an advance directive in Pennsylvania?
Not exactly. In Pennsylvania, a living will is one specific document: your written instructions about life-sustaining treatment. An advance health care directive is the umbrella term, defined in the statute as a health care power of attorney, a living will, or a written combination of the two. The example form at 20 Pa.C.S. § 5471 is the combined version.
Can my spouse, children, or health care agent witness my advance directive in Pennsylvania?
Yes. Unusually, Pennsylvania does not disqualify relatives, heirs, or the person you name as agent from witnessing. The only restrictions are that a witness must be 18 or older and that someone who signed the document on your behalf cannot also witness it. Where you can, disinterested witnesses are still the safer choice.
Does Pennsylvania have an official advance directive form I must use?
No form is mandatory. The statute prints an example, the Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will) at 20 Pa.C.S. § 5471, and any writing that meets the execution rules is valid. The statutory example is free and tracks Pennsylvania law exactly, which makes it a sensible default.
When does a living will take effect in Pennsylvania?
Only when three conditions are all met: a copy has been given to your attending physician, you have been determined to be incompetent, and you have been determined to have an end-stage medical condition or to be permanently unconscious. Until then it is dormant, which is why delivering copies matters as much as signing.
Does Pennsylvania have an advance directive registry?
No. Chapter 54 creates no registry and the state does not operate one, so no one will find your directive automatically. Give copies to your health care agent, your doctor, and your local hospital, and tell your family where the original is.
Can someone under 18 make a living will in Pennsylvania?
Sometimes, yes. Pennsylvania lets a person under 18 execute an advance directive if they have graduated from high school, are married, or are legally emancipated. That is broader than most states, which draw a hard line at 18.
Sources
This guide is general information, not legal advice. Laws change. For advice about your situation, consult a licensed attorney in Pennsylvania.