Medical Power of Attorney: Health Care Proxy Rules by State

A medical power of attorney, also called a health care power of attorney, a durable power of attorney for health care or a health care proxy, is a signed document in which you name an agent to make health care decisions for you if you become unable to make them yourself. The Uniform Health-Care Decisions Act (1993) describes it as a power that "may authorize the agent to make any health-care decision the principal could have made while having capacity," that "must be in writing and signed by the principal," and that "remains in effect notwithstanding the principal's later incapacity" (UHCDA Section 2(b)).

Each state writes its own version in a health care or advance directive statute, which is usually a different law from its financial power of attorney act. That is why the name of the document, how it must be signed, who may serve as your agent and when the agent's authority starts all depend on your state.

Scope: This page compares state health care power of attorney laws in the 50 states and the District of Columbia, using the Uniform Health-Care Decisions Act (the model law) and each state's own statute. It does not cover financial powers of attorney, which our guide to power of attorney types and state signing rules explains, and it does not teach end-of-life treatment choices. The words of your own document matter as much as the statute. This is legal information, not legal advice.

What a Medical Power of Attorney Does

A health care power of attorney puts a person you trust in charge of medical decisions when you cannot speak for yourself. The National Institute on Aging (NIA) describes it as "a legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself," and notes that the proxy is "also known as a representative, surrogate, or agent."

Under the 1993 model act, the agent decides "in accordance with the principal's individual instructions, if any, and other wishes to the extent known," and otherwise "in accordance with the agent's determination of the principal's best interest" (Section 2(e)). The act adds that "a health-care decision made by an agent for a principal is effective without judicial approval" (Section 2(f)).

The model act sets a low bar for signing. Its official comment says the power "must be in writing and signed by the principal, although it need not be witnessed or acknowledged." Many states added witness or notary requirements, and the signing rules by state are in the tables below.

What the document is called in each state

The same kind of document goes by different names. Using your state's name helps when you look for your state's form or statute.

• Health care proxy: New York (Public Health Law art. 29-C) and Massachusetts (M.G.L. c. 201D).
• Medical power of attorney: Texas (Health and Safety Code 166.151 to 166.166).
• Medical durable power of attorney: Colorado (C.R.S. 15-14-503 to 15-14-509, the Colorado Patient Autonomy Act).
• Designation of health care surrogate: Florida (Fla. Stat. ch. 765, the Florida Health Care Surrogate Act).
• Patient advocate designation: Michigan (MCL 700.5506 to 700.5515).
• Proxy directive naming a health care representative: New Jersey (N.J.S.A. 26:2H-53 and following).
• Health care agency, or power of attorney for health care: Illinois (755 ILCS 45, Article IV).
• Power of attorney for health care inside an advance health care directive: California (Probate Code 4671).
• Durable power of attorney for health care: Ohio (R.C. 1337.11 to 1337.17) and Arkansas (A.C.A. 20-6-103).
• Durable health care power of attorney: Montana (MCA 72-5-501).
• Advance directive naming a health care agent: Georgia (O.C.G.A. 31-32-1 and following) and Virginia (Va. Code 54.1-2981 and following).
• Health care power of attorney: North Carolina (G.S. 32A-15 to 32A-27), Pennsylvania (20 Pa.C.S. 5451 to 5465) and Arizona (A.R.S. 36-3221 and following), where a separate mental health care power of attorney also exists (36-3281 and following).
• Power of attorney for health care under the 2023 uniform act: Delaware (16 Del. C. ch. 25) and Utah (Utah Code Title 75A, ch. 9).
• Health care authority in a general power of attorney: Washington, where language granting general authority over health care matters makes the agent able to give informed consent (RCW 11.125.400).
• A mandate with express health care authority: Louisiana, whose Civil Code requires authority to "make health care decisions, such as surgery, medical expenses, nursing home residency, and medication" to be given expressly (La. C.C. art. 2997(6)).

Medical POA vs Living Will, POLST, Financial POA and HIPAA Release

People often mix these documents up. Each does a different job, and many people sign more than one.

NIA calls the living will and the durable power of attorney for health care "the two most common advance directives for health care." It also notes that "an advance directive is legally recognized but not legally binding," and that "a lawyer can help but is not required to create your advance directives." Availability of POLST-type forms varies; NIA suggests checking with your state department of health.

A financial POA usually does not cover medical decisions. The uniform act's statutory form says so in its own words (Section 301). Some states address the overlap directly. Washington lets general health care language in a power of attorney authorize informed consent and make the agent a HIPAA personal representative, "unless the power of attorney otherwise provides" (RCW 11.125.400).

North Carolina says a health care power of attorney "shall not confer any power or authority with respect to the property or financial affairs of the principal" (G.S. 32A-19(d)). New York goes further: a health care proxy "shall not be executed on a form or other writing that also includes the execution of a power of attorney" (PHL 2981(5)(e)), so a New York resident signs two separate documents.

Medical records. Under the federal privacy rule, "if under applicable law a person has authority to act on behalf of an individual who is an adult or an emancipated minor in making decisions related to health care, a covered entity must treat such person as a personal representative," limited to "protected health information relevant to such personal representation" (45 CFR 164.502(g)(2)). A health care agent with authority under state law fits that text; a financial-only agent, by that text, does not. Illinois writes the point into its statute: "A health care agent is a personal representative under state and federal law" (755 ILCS 45/4-4(e-5)).

How to Sign a Medical Power of Attorney: Rules in All 50 States and DC

Signing rules fall into a handful of patterns. The tables below give each state's rule and its statute; the state page linked from each name has the details, including who may not witness.

• A notary or two witnesses, your choice: Alaska, Arkansas, California, Hawaii, Indiana, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Nebraska, Nevada, New Hampshire (a notary or justice of the peace), New Jersey (a notary, attorney or other person authorized to administer oaths), North Dakota, Ohio, Oklahoma (for a power of attorney for health care; an advance directive, which Oklahoma requires to authorize withholding or withdrawing life-sustaining treatment, needs two witnesses), Oregon, Rhode Island, South Dakota, Tennessee, Texas, Washington (through its general power of attorney signing rule) and Wyoming.
• A notary or one witness: Arizona.
• Two witnesses, no notary option: Alabama, Connecticut, District of Columbia, Florida, Georgia, Maine, Maryland, Massachusetts, Michigan, New York, Pennsylvania, South Carolina, Vermont, Virginia and Wisconsin.
• One witness, no notary: Delaware, Illinois and Utah.
• Two witnesses and a notary: North Carolina and West Virginia.
• Signature only; no witness or notary required: Idaho and New Mexico.
• A notary acknowledgment, through the financial POA test: Missouri.
• No witness or notary rule located in the health care sections: Colorado and Montana, both of which require a writing.
• A mandate with express authority: Louisiana, where we located no health-care-specific witness or notary rule.

Two witnesses is common, but it is not a national rule. A few of these cells rest on compiled statute text that we have not matched against the state's current official code (Arkansas, Georgia, Mississippi, Ohio and Tennessee); the state pages carry the latest check.

Northeast

The Midwest has the widest spread, from one witness in Illinois to a notary through the financial test in Missouri.

Midwest

The South Atlantic states and DC hold both of the states that require witnesses and a notary, plus Delaware, one of the two states we confirmed under the 2023 uniform act.

South: Atlantic states and DC

The central South includes Louisiana, whose civil-law mandate works differently from a health care statute elsewhere.

South: central states

Louisiana's rule needs a word of explanation. Its Civil Code says "the contract of mandate is not required to be in any particular form," but "when the law prescribes a certain form for an act, a mandate authorizing the act must be in that form" (art. 2993). Health care authority must be given expressly (art. 2997(6)).

Louisiana's consent statute lists "an agent acting pursuant to a valid mandate, specifically authorizing the agent to make health care decisions" among the people who may consent for a patient who cannot, ranked after a judicially appointed tutor or curator and before the spouse (La. R.S. 40:1159.4(A)(3)). Louisiana's separate living-will declaration needs two witnesses (R.S. 40:1151.2).

The West is split into its Mountain and Pacific states. Two Mountain states require no witness or notary at all, and two others state none in their health care sections.

West: Mountain states

Montana's health care power of attorney must contain the words "This health care power of attorney is not affected by subsequent disability or incapacity of the principal or lapse of time," or "This health care power of attorney becomes effective upon the disability or incapacity of the principal," or similar words (MCA 72-5-501(1)). Montana's separate end-of-life declaration under its Rights of the Terminally Ill Act "must be witnessed by two individuals" (MCA 50-9-103(1)).

The Pacific states mostly accept a notary or two witnesses; Washington gets there through its general power of attorney law.

West: Pacific states

Washington's witnesses must be "neither home care providers ... nor care providers at an adult family home or long-term care facility in which the principal resides," and must be "unrelated to the principal or agent by blood, marriage, or state registered domestic partnership" (RCW 11.125.050(1)). Washington also has a separate "health care directive" about life-sustaining treatment, signed before a notary or two witnesses (RCW 70.122.030(1)).

Who may not witness

Many states disqualify certain people as witnesses, and the lists are specific. In the statutes we read:

• Florida: "The person designated as surrogate shall not act as witness," and at least one witness "shall be neither the principal's spouse nor blood relative" (Fla. Stat. 765.202(2)).
• New York: the agent may not witness, and the witnesses must state that the principal "appeared to execute the proxy willingly and free from duress." Remote witnessing by audio-video is allowed on the statute's conditions (PHL 2981(2), (2-a)).
• Massachusetts: the named agent may not witness, and the witnesses affirm in writing that the principal appeared to be at least 18, "of sound mind and under no constraint or undue influence" (c. 201D, s. 2).
• California: a witness may not be your health care provider or the provider's employee, the operator or an employee of a care facility, or the agent, and at least one witness must be neither related to you "by blood, marriage, or adoption" nor entitled to part of your estate (Prob. Code 4674).
• Texas: both witnesses must be competent adults, and at least one may not be, among others, the agent, a relative by blood or marriage, someone entitled to part of your estate, your attending physician or the physician's employee, or certain facility employees (Health & Safety Code 166.003).
• Michigan: a witness may not be your "spouse, parent, child, grandchild, sibling, presumptive heir, known devisee," your physician or patient advocate, or an employee of a life or health insurer, a treating health facility or a home for the aged (MCL 700.5506).
• North Carolina: a qualified witness may not be related within the third degree to you or your spouse, expect to inherit, have a claim against your estate, or be your attending physician, your mental health treatment provider, or a paid employee of either or of the facility where you live (G.S. 32A-16(6)).
• Georgia: a witness may not be your health care agent, someone who will knowingly inherit, or someone "directly involved in the declarant's health care," and no more than one witness may be an employee, agent or medical staff of the facility treating you (O.C.G.A. 31-32-5(c)(2)-(3)).
• Arizona: the notary or witness may not be the agent or "a person directly involved with the provision of health care to the principal at the time," and a single witness may not be related to you or take from your estate (A.R.S. 36-3221(C)-(D)).
• Arkansas: a witness must be a competent adult who is not the agent, and at least one must be unrelated to you and not entitled to part of your estate (A.C.A. 20-6-103(c)(2)).
• Illinois: a witness may not be your attending physician or other listed health care professional (or their relatives), a facility owner or operator (or a relative), your or any agent's parent, sibling or descendant or their spouse, or an agent (755 ILCS 45/4-5.1(a)).
• Delaware and Utah: the single witness may not be the agent or the agent's spouse or cohabitant (Delaware adds a domestic partner), and both also exclude certain facility staff; Utah's list names an owner, operator, employee or contractor of a facility where you live (16 Del. C. 2508(d); Utah Code 75A-9-107(4)).

Who Can Be Your Health Care Agent

You can usually name any adult you trust. NIA notes that "in most states, a health care proxy must be age 18 or older." The limits that do exist often target people who already have power over your care, a concern the 1993 model act's comment ties to "the special vulnerability of individuals in residential long-term health-care institutions." The model act bars an owner, operator or employee of a residential long-term health-care institution where you receive care, unless related to you "by blood, marriage, or adoption" (Section 2(b)).

State versions vary. In the statutes we read:

• California: the supervising health care provider, an employee of the institution where you receive care, or an operator or employee of a community or residential care facility may not act as your agent, with exceptions for relatives and co-employees (Prob. Code 4659).
• Texas: your health care provider or residential care provider, or an employee of either unless a relative, may not exercise an agent's authority (Health & Safety Code 166.153).
• Pennsylvania: unless related by blood, marriage or adoption, the agent may not be your attending physician or other health care provider, or an owner, operator or employee of a provider where you receive care (20 Pa.C.S. 5455(b)).
• New York: an operator, administrator or employee of a hospital where you are a patient or have applied may not serve unless a relative; a physician may serve but may not then be your attending physician; and New York limits how many principals one person may serve, to ten, with an exception for close family (PHL 2981(3)).
• Massachusetts and New Jersey: an operator, administrator or employee of a facility where you are a patient or resident (in Massachusetts, also one you have applied to) may not serve unless related to you (c. 201D, s. 3; N.J.S.A. 26:2H-58(a)(2)).
• Illinois: neither your attending physician nor any other health care provider may act as agent, but "a person who is not administering health care to the patient may act" (755 ILCS 45/4-5).
• Ohio: your attending physician and the administrator of a nursing home where you receive care may not be named, and neither may an employee or agent of your attending physician or of a health care facility treating you, unless that person is a competent adult related to you by blood, marriage or adoption or a member of the same religious order (R.C. 1337.12(A)(2)).
• Georgia: a physician or provider "directly involved in the declarant's health care may not serve" (O.C.G.A. 31-32-5(d)).
• North Carolina: the agent must be a competent person 18 or older "who is not engaged in providing health care to the principal for remuneration" (G.S. 32A-18).
• Washington: unless a spouse, registered domestic partner, parent, adult child or sibling, your physicians, their employees, and the owners, administrators or employees of a facility where you live or receive care may not act (RCW 11.125.400(3)).
• Delaware and Utah: owners, operators, employees and contractors of a facility where you live are barred unless they are family or a cohabitant (16 Del. C. 2508(b)(2); Utah Code 75A-9-107(2)(b)).

So a doctor or nursing home employee is not always barred: several of these states make an exception for relatives, and Illinois allows a physician who is not treating you. Consider naming a backup agent too, in case your first choice cannot serve.

When the Agent's Authority Starts

In the statutes we read, a health care agent generally steps in only after a physician determines that you can no longer decide, and steps back if you recover. The model act says that "unless otherwise specified in a power of attorney for health care, the authority of an agent becomes effective only upon a determination that the principal lacks capacity, and ceases to be effective upon a determination that the principal has recovered capacity" (UHCDA Section 2(c)). The primary physician makes that determination unless the document says otherwise (Section 2(d)).

States differ on who decides and how:

• Texas: the agent may act "only if the principal's attending physician certifies in writing and files the certification in the principal's medical record" that the principal is incompetent (Health & Safety Code 166.152(b)).
• Pennsylvania: the document becomes operative when a copy is given to the attending physician and the attending physician determines that the principal is incompetent, unless it says otherwise (20 Pa.C.S. 5454(a)).
• Massachusetts: the attending physician makes a written determination, and "a physician who has been appointed as a patient's agent shall not make the determination" (c. 201D, s. 6).
• Michigan: the attending physician and another physician or a licensed psychologist must determine in writing that the patient cannot participate in treatment decisions, and the determination is reviewed at least annually (MCL 700.5508(1)).
• North Carolina: the physician or physicians you designate decide in writing; if you designated none, the attending physician decides (G.S. 32A-20(a)).
• Virginia: the attending physician certifies in writing "upon personal examination," a capacity reviewer generally also certifies, and the finding must be renewed at least every 180 days. Virginia adds that "no person shall be deemed incapable of making an informed decision based solely on a particular clinical diagnosis" (Va. Code 54.1-2983.2).
• New Jersey: the directive becomes operative once it reaches the attending physician or institution and a determination is made that the patient lacks capacity "to make a particular health care decision" (N.J.S.A. 26:2H-59(a)).

A few states let the document start sooner. Florida lets the principal stipulate that the surrogate's authority is "exercisable immediately without the necessity for a determination of incapacity" (Fla. Stat. 765.202(6)). Ohio lets the document give the agent access to health information "commencing immediately upon the execution of the instrument" (R.C. 1337.12(A)(1)). Delaware lets a power of attorney give the agent information access that "commences on appointment" (16 Del. C. 2518(c)).

Decisions a Health Care Agent Cannot Make Without Specific Authority

A health care agent's power is broad but not unlimited. Many statutes list decisions an agent may not make, or may make only with specific written authority. The lists differ, so read your state's.

• California: the law does not authorize an agent to consent to "commitment to or placement in a mental health treatment facility," convulsive treatment, psychosurgery, sterilization or abortion (Prob. Code 4652).
• Texas: an agent may not consent to voluntary inpatient mental health services, convulsive treatment, psychosurgery, abortion, or "neglect of the principal through the omission of care primarily intended to provide for the comfort of the principal" (Health & Safety Code 166.152(f)).
• Florida: unless the principal expressly delegated the authority in writing or a court approves, a surrogate may not consent to "abortion, sterilization, electroshock therapy, psychosurgery, experimental treatments" (on the statute's conditions), or voluntary admission to a mental health facility (Fla. Stat. 765.113).
• Virginia: the Act "shall not apply to authorization of nontherapeutic sterilization, abortion, or psychosurgery," and admission to a mental health facility must be otherwise authorized under Title 37.2 (Va. Code 54.1-2983.3).
• Ohio: an agent may not refuse or withdraw consent to life-sustaining treatment unless the principal is in a terminal condition or a permanently unconscious state and other conditions are met (R.C. 1337.13(B)(1)).
• Michigan: a patient advocate may decide to withhold or withdraw treatment that would allow the patient to die "only if the patient has expressed in a clear and convincing manner that the patient advocate is authorized" to do so (MCL 700.5509(1)(e)).
• New York: if the principal's wishes about artificial nutrition and hydration "are not reasonably known," the agent "shall not have the authority to make decisions regarding these measures" (PHL 2982(2)).
• Pennsylvania: without specific written authorization, the agent "shall presume that the principal would not want nutrition and hydration withheld or withdrawn," a presumption that can be rebutted (20 Pa.C.S. 5456(c)(5)(iii)).
• Washington: the agent's health care authority "is subject to the same limitations as those that apply to a guardian," and a guardian needs court authority for convulsive therapy, psychosurgery and other mental health procedures that restrict physical freedom of movement (RCW 11.125.400(3); 11.130.335(3)).

Mental health decisions sometimes get their own document. Arizona has a separate mental health care power of attorney, and authority for inpatient psychiatric admission must be "separately initialed by the principal" (A.R.S. 36-3282(B)). North Carolina lets a health care power of attorney include "the power to authorize the giving or withholding of mental health treatment" (G.S. 32A-19(a)). Delaware's 2023 act bars a voluntary mental health admission unless the power of attorney specifically authorizes it, and limits its length (16 Del. C. 2518(e)).

Your objection can count. In Colorado, "no agent may consent to or refuse medical treatment for a principal over the principal's objection" (C.R.S. 15-14-506(4)(a)). Texas says treatment may not be given or withheld if the principal objects (Health & Safety Code 166.152(c)). Georgia gives an agent no authority to act contrary to the principal's own decision if the principal "is able to understand the general nature of the health care procedure" (O.C.G.A. 31-32-7(a)). Pennsylvania lets a principal countermand an agent's decision (20 Pa.C.S. 5457).

Revoking a Medical Power of Attorney, Divorce and a Newer Document

Health care revocation rules are separate from the financial POA rules covered in our guide to revoking a power of attorney, and they are often looser. The 1993 model act lets a person "revoke the designation of an agent only by a signed writing or by personally informing the supervising health-care provider," and revoke other parts "at any time and in any manner that communicates an intent to revoke" (Section 3(a)-(b)).

Several states let a principal revoke even after losing capacity:

• Texas: by oral or written notice to the agent or a licensed or certified health or residential care provider, or any other act showing intent, "without regard to whether the principal is competent or the principal's mental state" (Health & Safety Code 166.155(a)(1)).
• Illinois: "at any time, without regard to the principal's mental or physical condition," by destroying it, a signed and dated writing, or an oral statement before a witness 18 or older who signs a confirming writing (755 ILCS 45/4-6(a)).
• Georgia: "without regard to the declarant's mental state or competency," by several listed methods, including an oral statement before a witness who confirms it in writing within 30 days (O.C.G.A. 31-32-6(a)).
• Michigan: even a patient unable to participate in treatment decisions "may revoke ... at any time and in any manner by which he or she is able to communicate an intent to revoke" (MCL 700.5510(1)(d)).
• Massachusetts: "every principal shall be presumed to have the capacity to revoke" unless a court order says otherwise (c. 201D, s. 7).

Other states tie revocation to the principal's condition or to notice. North Carolina allows revocation "so long as the principal is capable of making and communicating health care decisions," effective once communicated to each named agent and the attending physician (G.S. 32A-20(b)). Virginia's revocation is effective "when communicated to the attending physician" (Va. Code 54.1-2985(A)). California lets a patient having capacity revoke the agent's designation "only by a signed writing or by personally informing the supervising health care provider" (Prob. Code 4695(a)).

A newer document. In the statutes we read, a later health care directive replaces an earlier one, at least where they conflict: California says a later conflicting directive revokes the earlier one "to the extent of the conflict" (Prob. Code 4698), New York says a later proxy revokes an earlier one (PHL 2985(1)(c)), and Ohio says a later valid health care power of attorney revokes an earlier one unless it says otherwise (R.C. 1337.14(C)). That can differ from the rule for financial POAs, so do not assume one rule covers both.

Divorce. Many states end a spouse's appointment as health care agent on divorce, and they pick different moments. Most of the statutes below let the document keep the spouse as agent; those of California, Virginia, North Carolina, Massachusetts and Michigan state no such exception, though in North Carolina and Michigan a named successor agent serves instead:

• On filing: Pennsylvania, where the designation is revoked "as of the time the action is filed unless it clearly appears from the advance health care directive that the designation was intended to continue" (20 Pa.C.S. 5430(a)); Virginia, where filing for divorce or annulment, or a petition for custody or visitation of a child of the principal and agent, revokes the agent's authority (Va. Code 54.1-2985(A1)); Delaware, on a divorce petition filed and not dismissed, a decree, an agreed legal separation or desertion for over a year (16 Del. C. 2515(d)); and Utah, on similar events (Utah Code 75A-9-114(4)).
• On the decree: California, when the marriage "is dissolved or annulled" (Prob. Code 4697(a)); Texas, when the marriage is "dissolved, annulled, or declared void unless the medical power of attorney provides otherwise" (Health & Safety Code 166.155(a-1)); and North Carolina, "upon the entry by a court of a decree of divorce or separation" (G.S. 32A-20(c)).
• Suspended, then revoked: Michigan suspends a spouse-advocate's designation while a separate maintenance, annulment or divorce action is pending and revokes it on judgment, unless the patient named a successor (MCL 700.5510(1)(g)).
• On divorce, dissolution or legal separation, with no timing stated in the section: Florida (765.104(2)), New York (PHL 2985(1)(e), divorce or legal separation), New Jersey (26:2H-57(c)), Massachusetts (c. 201D, s. 7), Colorado (C.R.S. 15-14-506(5)(c)) and Georgia, which also says a marriage after signing revokes the designation of a non-spouse agent unless the directive says otherwise (O.C.G.A. 31-32-6(b)).

Other states have their own rules, sometimes in a different code. If you divorce, consider signing a new health care power of attorney rather than relying on the statute.

Is a Medical Power of Attorney From Another State Valid?

Often, but the rule comes from the state where the document is used. The 1993 model act treats a directive as valid "if it complies with this [Act], regardless of when or where executed or communicated" (Section 2(h)). In the statutes we read, these states expressly recognize health care powers of attorney or directives made elsewhere, each on its own terms:

• California (Prob. Code 4676(a)), New York (PHL 2990), New Jersey (N.J.S.A. 26:2H-76), North Carolina (G.S. 32A-27), Florida (Fla. Stat. 765.112), Georgia (O.C.G.A. 31-32-5(b)), Virginia (Va. Code 54.1-2993), Massachusetts (c. 201D, s. 11), Arizona (A.R.S. 36-3208) and Arkansas (A.C.A. 20-6-103(h)).
• Pennsylvania recognizes one "except to the extent" it allows decisions "inconsistent with the laws of this Commonwealth" (20 Pa.C.S. 5464).
• Ohio recognizes instruments that "substantially comply" (R.C. 1337.16).
• Colorado presumes a document from another state complies and says it "may, in good faith, be relied upon" (C.R.S. 15-14-509(2)).

If you spend time in more than one state, consider asking a provider in the second state whether your document will work there, or signing one that meets both states' rules.

Guardianship, Death and the Health Care Agent

A court guardianship does not automatically wipe out a health care power of attorney. In Washington, "a guardian for an adult does not have the power to revoke or amend a power of attorney for health care" executed by the adult, though the court can (RCW 11.130.335(1)). In Pennsylvania, the court that appoints a guardian "shall determine the extent to which the health care agent's authority ... remains in effect" (20 Pa.C.S. 5460(a)).

In Georgia, appointing a guardian does not by itself revoke a health care directive (O.C.G.A. 31-32-6(c)). In Montana, by contrast, a guardian "has the same power to revoke or amend the health care power of attorney that the principal would have had" (MCA 72-5-501(2)). If no valid health care document exists and the person can no longer decide, a court process may be needed; our guardianship guide explains how it works by state.

A financial POA ends at death, as our page on whether a power of attorney ends at death explains. Some health care statutes give the agent a role around death: California lets the agent decide on an anatomical gift, an autopsy and the disposition of remains, unless the document limits it (Prob. Code 4683(b)).

Recent Changes: The 2023 Uniform Health-Care Decisions Act

The Uniform Law Commission's newer model, the Uniform Health-Care Decisions Act (2023), is now law in at least two states.

• Delaware: 16 Del. C. ch. 25 "may be cited as the 'Uniform Health-Care Decisions Act (2023)'" (delcode.delaware.gov). The session law, 84 Del. Laws c. 467, was approved September 30, 2024 and "takes effect 1 year from the date of the Act's enactment," which is September 30, 2025. A health care power of attorney now needs a record signed by the individual and one adult witness (2508(d)).
• Utah: Utah Code Title 75A, chapter 9, enacted by Chapter 439 of the 2025 General Session, "applies to an advance health care directive created before, on, or after January 1, 2026" (75A-9-129). It also requires one adult witness (75A-9-107(4)).

Both define the capacity needed to appoint an agent in modest terms: the person "recognizes the identity of the individual being appointed or identified and understands the general nature of the relationship" (16 Del. C. 2503(a)(3); Utah Code 75A-9-102(1)(b)(iii)). Other states may adopt the 2023 act; the state pages track each state's current law.

Common Mistakes With Medical Powers of Attorney

These errors and gaps show up in online guides to the topic:

1. Assuming a financial POA covers medical decisions. The uniform financial form says it does not, and a few states, like New York, require a separate document.
2. Using the wrong signing rule. Some guides say Florida accepts "two witnesses or a notary"; Florida's statute requires two subscribing adult witnesses and states no notary alternative (765.202(1)). Some also list South Carolina among states needing witnesses and a notary; its health care statute calls for two witnesses (62-5-503(a)). North Carolina and West Virginia are the two states that require both.
3. Letting the wrong person witness. The agent is a common disqualified witness, and many states add relatives, heirs or care staff. Check your state's list before signing day.
4. Expecting the agent to act right away. In the statutes we read, the agent generally waits for a physician's determination of incapacity unless the document says otherwise.
5. Forgetting to update after a divorce or a move. Divorce rules differ, and recognition of out-of-state documents depends on the new state.
6. Keeping the only copy in a drawer. A document nobody can find cannot help. Consider giving copies to your agent, your backup agent and your doctors; Michigan requires the designation to be made part of the patient's medical record before the advocate acts (MCL 700.5506).

Practical Steps to Make a Medical Power of Attorney

1. Find your state's name for the document and its statute in the lists above, and open your state page.
2. Choose an agent and a backup who is willing, reachable and not barred by your state's rules.
3. Talk with them about your wishes. The agent follows your known wishes first, and your best interest otherwise (UHCDA Section 2(e)).
4. Sign it the way your state requires, with the right number and kind of witnesses or a notary. In Michigan the agent must also sign an acceptance.
5. Consider a living will as well, and ask your doctor whether a POLST-type form fits your situation.
6. Give copies to your agent, backup agent and doctors, and review the document after a divorce, a move or a change in health.

Medical Power of Attorney by State

Each state page covers that state's health care power of attorney rule alongside its financial POA law:

• California, Florida, Georgia, Illinois, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia and Washington.
• The remaining states are linked in the signing tables above.

If you are arranging these documents for a parent, our guide to power of attorney for an elderly parent covers capacity, choosing agents and what to do if a parent can no longer sign.

Where to Get Help

• Forms: NIA notes that "many states have their own forms that you can access and complete for free," and that a lawyer "can help but is not required." Your state health department or court self-help center is a common place to look.
• Legal aid: legal aid organizations help people with low incomes and can tell you whether they assist with these documents.
• Lawyer referral: your state bar's lawyer referral service can connect you with a lawyer who handles estate planning or elder law.
• A dispute over an agent's decisions: the court in your county that hears guardianship matters can tell you how to raise it, and its self-help center can explain the forms.

Legal information, not legal advice. This page summarizes health care power of attorney laws in the 50 states and the District of Columbia as our research read the statutes in November 2026. Laws change, and the right document depends on your situation and your state. Before signing a health care power of attorney or acting as someone's agent, consider talking with a lawyer licensed in your state.

Frequently Asked Questions

What is a medical power of attorney?

A medical power of attorney, also called a health care power of attorney or health care proxy, is a signed document naming a person (your agent) to make health care decisions for you if you become unable to make them yourself. Each state sets its own rules for it in a health care statute.

Is a health care proxy the same as a medical power of attorney?

Generally yes. 'Health care proxy' is the name New York and Massachusetts use for the document, and NIA uses 'proxy' for the person named. Other states call it a medical power of attorney (Texas), a designation of health care surrogate (Florida), a patient advocate designation (Michigan) or a health care power of attorney.

What is the difference between a medical power of attorney and a living will?

A medical power of attorney names a person to decide for you. A living will gives written instructions about the treatment you want if you cannot decide. Many people sign both, and some states combine them in one advance directive form.

Does a medical power of attorney need to be notarized?

It depends on the state. Many states accept either a notary or two witnesses, others require two witnesses and no notary, Delaware, Illinois and Utah require one witness, North Carolina and West Virginia require two witnesses and a notary, and Idaho and New Mexico require no witness or notary. Check your state's rule before signing.

Does a regular power of attorney cover medical decisions?

Usually not. The uniform financial power of attorney form states that it does not authorize health care decisions, and health care agents are created under separate state health care laws. Washington is an exception: language granting general authority over health care matters in a power of attorney gives the agent health care authority unless the document says otherwise.

Who can be my health care agent?

Generally any adult you trust who is willing to serve. Many states bar your treating doctor or other provider, or the owner, operator or staff of a facility where you are a patient or resident, often with an exception for relatives. Your state page lists who is barred.

When does a medical power of attorney take effect?

In the statutes we read, the agent's authority generally starts only after a physician determines that you can no longer make your own health care decisions, unless the document says otherwise. Florida lets you make the surrogate's authority exercisable immediately, and Ohio lets the agent obtain your health information from signing.

Can my health care agent get my medical records?

Under the federal HIPAA privacy rule, a person who has authority under state law to make your health care decisions is treated as your personal representative for the health information relevant to that role (45 CFR 164.502(g)(2)). A financial-only agent does not have that status under that text.

Can my agent override what I want?

The agent must follow your known wishes and otherwise act in your best interest under the model act. Several states also say your objection controls: Colorado bars an agent from consenting to or refusing treatment over your objection, and Texas says treatment may not be given or withheld if you object.

Does divorce cancel my spouse as my health care agent?

In many states, yes, and the trigger differs. Some states, such as Pennsylvania and Texas, let your document keep your spouse as agent; California, Virginia and North Carolina state no such exception. Pennsylvania, Virginia, Delaware and Utah act on the filing, California, Texas and North Carolina on the decree, and Michigan suspends the designation while the case is pending. Consider signing a new document after a divorce.

Can I revoke my medical power of attorney?

Yes. The health care statutes we read generally let you revoke by telling your agent or your provider, in writing or orally, and some, including Texas, Illinois and Georgia, allow revocation regardless of your mental state. Others, such as North Carolina, require that you still be able to make and communicate health care decisions.

Is my medical power of attorney valid in another state?

Often, but it depends on the state where it is used. Many states, including California, New York, Florida and Virginia, expressly recognize documents valid where they were made, and Pennsylvania excludes decisions inconsistent with its own law. If you split time between states, consider checking with a provider in the second state.

Do I need a lawyer to make a medical power of attorney?

Generally no. NIA says a lawyer can help but is not required to create advance directives. A lawyer can be useful if your situation is complicated, such as a blended family, property in several states or a disagreement among relatives.