How do I create an advance healthcare directive in Pennsylvania?
1. Types Recognized
Pennsylvania recognizes under 20 Pa.C.S. Ch. 54: (a) Living Will (§ 5442 — instructions for end-stage medical condition/permanent unconsciousness), (b) Health Care Power of Attorney (§ 5452) designating an agent, (c) combined Advance Health Care Directive, (d) POLST (Pennsylvania Orders for Life-Sustaining Treatment), and (e) DNR.
2. Statutory Form
20 Pa.C.S. § 5471 provides a sample combined form. Use is optional but recommended; substantial compliance with the statute suffices.
3. Execution Formalities
Principal must be 18+ (or graduated from high school, married, or emancipated) and of sound mind (§ 5443). Sign or direct another to sign in presence, before TWO adult witnesses (§ 5452(b)). The agent CANNOT serve as a witness. The attending physician/healthcare provider cannot be witnesses. NO notary required.
4. Healthcare Agent Authority
Under § 5456, the agent may make any healthcare decision the principal could make. To authorize withholding life-sustaining treatment for an end-stage medical condition or permanent unconsciousness, the principal should expressly state so. The agent's authority begins when the attending physician determines the principal is incompetent (§ 5454).
5. Pregnancy Clauses
20 Pa.C.S. § 5429 PROHIBITS withdrawal of life-sustaining treatment from a pregnant patient unless treatment would not maintain her in a way to allow continued fetal development to live birth, or treatment would cause her substantial pain not alleviated by medication. This remains in force post-Dobbs.
6. Reciprocity
Section 5432 honors directives executed in compliance with the law of another state.
7. POLST
Pennsylvania POLST is a physician-signed bright-pink order portable across settings, recognized statewide under DOH guidelines and § 5483.
8. Revocation
Under § 5459, revocable at any time, regardless of mental capacity, by: writing, oral declaration to a healthcare provider, physical destruction, or a contrary new directive.
9. Default Surrogate
Section 5461 provides a "health care representative" hierarchy when no agent is named: spouse (and adult child of prior relationship together) > adult child > parent > adult sibling > adult grandchild > close friend > attending physician (only after consultation with ethics committee).
This is legal information, not legal advice.
- Pregnant patient seeking to override § 5429 restrictions
- Family dispute over representative hierarchy under § 5461
- Integrating directive with financial POA and estate plan
- 20 Pa.C.S. Ch. 54 (Healthcare Decisions Act)
- 20 Pa.C.S. § 5429 (pregnancy)
- 20 Pa.C.S. § 5461 (health care representative)
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.