Hawaii Living Will Requirements
Hawaii folds the living will into a single combined document rather than giving it its own statute.
Introduction
Hawaii folds the living will into a single combined document rather than giving it its own statute. Hawaii Revised Statutes Chapter 327E, the Uniform Health-Care Decisions Act (Modified), creates one instrument called the Advance Health-Care Directive, built from an individual instruction (your treatment wishes) and, if you choose, a power of attorney for health care (your named agent), filled out together on the same optional form. Put simply, the treatment-wishes piece is your written statement of the medical care you want, or don't want, if you become seriously ill or injured and cannot communicate for yourself. This guide covers that treatment-wishes half: what to say, how to sign it, and what makes it valid under Hawaii law. If you also want to name someone to make decisions for you, the agent-designation half is covered on the Hawaii Healthcare Power of Attorney page.
Key Things to Know
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Hawaii's optional advance-directive form has witnesses sign a single combined declaration, covering both their personal knowledge of you and their unrelated, non-inheriting status, rather than splitting these into two separate declarations the way some states' forms do. Underneath that detail, this is still your living will: a written statement of which medical treatments you want or want withheld if you cannot speak for yourself. It is not a document that names who decides for you.
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A living will is not a last will and testament. A living will governs medical care while you are alive but unable to communicate; a last will and testament governs who inherits your property after you die. Most people preparing one eventually want the other too.
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Hawaii does not have a stand-alone living-will form. Chapter 327E folds the treatment-wishes declaration and the health care power of attorney into one combined Advance Health-Care Directive.
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Section 327E-3's witnessing and notarization language is written for the power-of-attorney half of the statute; standing alone, a bare treatment-wishes instruction has no separate signature formality of its own in the code's literal text. Follow the same rule anyway: Hawaii's own optional form holds both halves to one shared signature block, so you can sign before two qualified adult witnesses or before a notary public, both routes equally valid, notarization is not a backup option.
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Artificial nutrition and hydration gets its own numbered paragraph on Hawaii's optional form. By default it follows your general treatment choice, but you can check a separate box requiring it regardless of that choice.
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Hawaii law does not include a pregnancy-exclusion clause. Nothing in Chapter 327E changes, suspends, or voids your directive if you are pregnant.
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You can revoke your treatment-wishes instructions at any time, in any manner that communicates your intent to revoke, a deliberately loose standard the law applies only to this treatment-wishes half. Revoking an agent's designation instead follows a separate, stricter rule; see Hawaii Healthcare Power of Attorney for that mechanic.
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Hawaii has no state registry for advance directives, unlike some other states. Keep copies with your physician, your named agent, and somewhere accessible at home.
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Electronic signatures are not accepted for a Hawaii Advance Health-Care Directive, per the Department of Health's own guidance.
Key decisions before you file
Before you file a Living Will in Hawaii, a few decisions shape the document: which option to choose and what each one means. The Living Will guide walks through them.
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Hawaii Requirements for Living Will
Hawaii does not have a legally separate living-will statute. Hawaii Revised Statutes Chapter 327E, the Uniform Health-Care Decisions Act (Modified), creates one combined instrument, the Advance Health-Care Directive, defined as either an individual instruction (treatment wishes), a power of attorney for health care (agent designation), or both together in one document.
An adult or emancipated minor may give an individual instruction about their own health care, oral or written, and may limit it to take effect only if a specified condition arises. This section authorizes you to state your own treatment wishes directly, without naming an agent.
Unless your directive specifies otherwise, whether you lack or have recovered capacity is determined by your primary physician, per Section 327E-3(f). Section 327E-11 separately confirms every adult is presumed to have capacity.
You may revoke all or part of your advance health-care directive, other than your agent designation, at any time and in any manner that communicates an intent to revoke, as long as you have capacity. Revoking your agent's designation requires a signed writing or personally informing your health care provider, a stricter standard.
If you use witnesses instead of a notary, Hawaii requires two adult witnesses. A witness may not be your agent, a health care provider, or an employee of a health care provider or facility. At least one witness must not be related to you by blood, marriage, or adoption and must not be entitled to any part of your estate. Witnessing is not mandatory; notarization is an equally valid, independently sufficient alternative.
Acknowledging your directive before a notary public anywhere in Hawaii is not a fallback for people who cannot find witnesses. Section 327E-3(b) makes notarization and two-witness signing two independently sufficient, co-equal ways to execute a valid directive.
This exact three-condition end-of-life language, an incurable and irreversible condition expected to cause death within a relatively short time, permanent unconsciousness, or risks and burdens outweighing expected benefits, appears in the optional statutory form at Section 327E-16.
The pain-relief election, a checkbox directing that treatment to alleviate pain be given even if it hastens death, is Section 327E-16, Part 2, paragraph (8).
Hawaii's Uniform Anatomical Gift Act lets you authorize organ and tissue donation. Hawaii's own optional Section 327E-16 statutory form includes a dedicated Part 3 for organ donation alongside its treatment-wishes and agent-designation sections, so most people handle both in the same document.
A health care provider must comply with your individual instruction and reasonable interpretations of it, unless the provider objects for reasons of conscience or the instruction requires care contrary to the provider's or institution's policy or generally accepted standards, in which case the provider must still give continuing care and help transfer you to a provider who will comply.
The out-of-state recognition rule, that a directive valid under Hawaii law or under the law of the state where it was executed is valid here, is subsection (j) of Section 327E-3.
Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Hawaii law to make an advance directive, including stating their own treatment wishes.
Federal HIPAA regulations govern how your health care agent can be authorized to access your protected health information once the agent-designation portion of your combined directive is in effect. This authorization supports the agent-decision-maker half of your directive; it does not change or expand your own treatment-wishes instructions.
Chapter 327G is a separate Hawaii statute from Chapter 327E. It lets a competent adult make a distinct advance mental health care directive, stating preferences about psychiatric medication, electroconvulsive treatment, and facility admission, and name a mental-health decision agent. Chapter 327G expressly allows this directive to be combined with your Chapter 327E Advance Health-Care Directive, but it is not automatically part of it. Your general health care instructions under Chapter 327E do not by themselves cover mental health treatment decisions to the same extent.
If you have no agent or guardian, or your agent is not reasonably available, Hawaii lets interested persons, such as a spouse, adult child, or parent, select a surrogate decision-maker following the statute's priority process. A surrogate who was not designated by you may only authorize withholding or withdrawing artificial nutrition and hydration if your primary physician and a second independent physician both certify that continuing it merely prolongs dying with no reasonable chance of neurological recovery.
The definition of 'health care' at Section 327E-2 expressly includes artificial nutrition and hydration. The specific election mechanic, a separate numbered paragraph on the optional form that follows your general choice unless you check a box requiring it regardless, is Section 327E-16, Part 2, paragraph (7).
A health care provider or institution acting in good faith and in accordance with generally accepted health care standards is not subject to civil or criminal liability, or professional discipline, for complying with, or declining to comply with, a health care decision, or for relying on an advance health-care directive it reasonably believed was valid and unrevoked. An agent, guardian, or surrogate acting in good faith has the same protection.
Death resulting from withholding or withdrawing health care under Chapter 327E is not suicide or homicide for any purpose and does not impair an insurance or annuity policy. The chapter does not authorize mercy killing, assisted suicide, or euthanasia, except that this prohibition does not apply to actions taken under Hawaii's separate Our Care, Our Choice Act (Chapter 327L).
Hawaii's Our Care, Our Choice Act lets a mentally capable, terminally ill adult with six months or less to live voluntarily request prescription medication to end their life. This is a separate legal process from your Advance Health-Care Directive: it requires your own contemporaneous, repeated request at the time under its own procedure, and is not something you can elect or pre-authorize through your living-will instructions.
Unlike some other states, Hawaii has no state-run registry for advance health-care directives. Instead, give copies of your signed directive to your physician, any treating health care institution, and your named agent, and keep a copy somewhere accessible at home.
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Check my Living WillFrequently Asked Questions
In Hawaii, a living will is the treatment-wishes half of the Advance Health-Care Directive, the single document Hawaii Revised Statutes Chapter 327E uses to cover end-of-life medical decisions. It lets you write down, in your own words or using the optional Section 327E-16 form's two-choice language, whether you want life-sustaining treatment continued or withheld if you become terminally ill or permanently unconscious. There is no separate Hawaii statute called a 'living will.' The term describes this part of the combined directive, not a stand-alone filing.
One Hawaii document does both jobs. The Advance Health-Care Directive (Hawaii Revised Statutes Chapter 327E) has a treatment-wishes half, the living will, where you state directly what care you want or refuse, and an agent-designation half, the health care power of attorney, where you name someone to decide for you on anything your instructions don't cover. You can sign either half alone or both together. For the agent-designation side specifically, see Hawaii Healthcare Power of Attorney.
These control completely different things at completely different times. A living will (part of your Hawaii Advance Health-Care Directive) states your medical treatment wishes while you are alive but unable to communicate. A last will and testament says who inherits your property after you die, and only takes legal effect at death. Having one does not replace the other. Most people executing an Advance Health-Care Directive for end-of-life care planning also want a separate Hawaii Last Will and Testament for their estate.
Not exactly, but Hawaii gives it more visibility than some states. The optional Section 327E-16 form addresses artificial nutrition and hydration in its own numbered paragraph, separate from your general end-of-life choice. By default, it follows whatever you chose for general treatment, but the form gives you a specific box to check if you want artificial nutrition and hydration provided regardless of that choice. There's no requirement to fill out that box, but it's there if your wishes on artificial nutrition and hydration differ from your general instruction.
It doesn't. Hawaii is one of the states whose Uniform Health-Care Decisions Act has never included a pregnancy-exclusion clause. Your directive keeps its full effect regardless of pregnancy status, unlike a handful of other states that do carve this out.
No, and this is a real difference from some other states. Hawaii has no state advance-directive registry. Instead, give copies of your signed directive to your physician, any health care institution treating you, and the person you've named as agent, and keep a copy somewhere easy for family to find.
Yes. Section 327E-3(j) treats an advance health-care directive validly executed under Hawaii law, or under the law of the state where it was executed, as valid here. You don't need to redo your paperwork just because you signed it somewhere else.
Not automatically. Mental health treatment decisions are covered by a separate Hawaii statute, the Advance Mental Health Care Directive under Chapter 327G, which lets you state preferences about psychiatric medication, treatment, and facility admission and name a mental-health decision agent. Chapter 327G lets you combine that directive with your Chapter 327E Advance Health-Care Directive, but they're governed by different statutes, so make sure both documents actually say what you want if mental health care matters to you.