How do I create an advance healthcare directive in Maryland?
1. Types Recognized
Maryland's Health Care Decisions Act (Md. Code Ann. Health-Gen. §§ 5-601 to 5-618) authorizes a combined Advance Directive that includes: (a) Treatment Preferences (living will section), (b) Healthcare Agent appointment, (c) MOLST (Medical Orders for Life-Sustaining Treatment) under Health-Gen. § 5-608.1, (d) DNR, and (e) Mental Health Advance Directive.
2. Statutory Form
Health-Gen. § 5-603 contains an Advance Directive form developed by the Attorney General. Use is optional but strongly recommended. Maryland also accepts directives recorded by audio/video (§ 5-602(d)).
3. Execution Formalities
Principal must be competent adult (18+). Sign or direct another to sign on principal's behalf, in the presence of TWO adult witnesses who also sign (Health-Gen. § 5-602(c)). One witness CANNOT be the agent. A witness cannot be entitled to any portion of the estate. NO notary required. Oral directives in front of physician and witness are permitted (§ 5-602(d)).
4. Healthcare Agent Authority
Under Health-Gen. § 5-605, the agent may make any healthcare decision the principal could make, including consent to/refusal of life-sustaining treatment and artificial nutrition/hydration. Authority becomes effective when two physicians certify the principal lacks capacity (§ 5-606).
5. Pregnancy Clauses
Maryland Health-Gen. § 5-603 form requires the patient to make a separate election regarding pregnancy. The statute does NOT impose an absolute pregnancy exclusion — patient choice controls.
6. Reciprocity
Health-Gen. § 5-617 honors advance directives validly executed in another state.
7. MOLST
Maryland MOLST (Health-Gen. § 5-608.1) is a mandatory form — required for patients in nursing homes, assisted living, hospice. Signed by physician/NP/PA, portable across care settings.
8. Revocation
Under Health-Gen. § 5-604, the advance directive may be revoked at any time, regardless of mental state, by: signed/dated writing, oral expression in presence of witness, physical destruction, or new directive that contradicts.
9. Default Surrogate
Health-Gen. § 5-605(a) provides surrogate priority for incapacitated patients without an agent: court-appointed guardian > spouse/domestic partner > adult child > parent > adult sibling > friend/other relative (with affidavit).
This is legal information, not legal advice.
- MOLST mandatory in long-term care — review interaction with directive
- Multiple eligible surrogates with disagreement
- Religious or conscience-based facility refusal to honor directive
- Md. Code Ann. Health-Gen. §§ 5-601 to 5-618 (Health Care Decisions Act)
- Md. Code Ann. Health-Gen. § 5-608.1 (MOLST)
- Md. Code Ann. Health-Gen. § 5-605 (surrogate priority)
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.