Nevada Living Will Requirements

Introduction

Key Things to Know

1. 1

   In Nevada, this document goes by the name 'declaration,' not 'living will': it is your written statement of which medical treatments you want, or want withheld, if you become unable to communicate, addressed directly to your physician or advanced practice registered nurse rather than naming someone to decide for you.

2. 2

   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.

3. 3

   Nevada has its own separate living-will statute, the declaration governing the withholding or withdrawal of life-sustaining treatment (NRS 449A.400 to 449A.481), completely apart from its health care power of attorney statute (NRS Chapter 162A).

4. 4

   Nevada recognizes only one trigger condition for this declaration: a terminal condition. There is no separate statutory category for permanent unconsciousness or persistent vegetative state.

5. 5

   Artificial nutrition and hydration is withheld by default once your declaration takes effect. You must separately initial a box if you want it continued instead.

6. 6

   Nevada law will not let this declaration withhold or withdraw life-sustaining treatment while you are known to be pregnant and the fetus is likely to reach live birth with continued treatment.

7. 7

   You need only two witnesses to sign this declaration. Nevada's declaration has no notary option, and the statute sets no qualification or disqualification rules for who may serve as a witness.

8. 8

   You can revoke this declaration at any time, in any manner, regardless of your mental or physical condition.

9. 9

   Registering your declaration with Nevada's Secretary of State Registry of Advance Directives for Health Care is optional. It is not required for your declaration to be valid.

Nevada Requirements for Living Will

• Declaration of Intent (Nevada Revised Statutes Section 449A.433)

  The declaration is a clear statement, executed under the Uniform Act on Rights of the Terminally Ill, of your wishes regarding withholding or withdrawal of life-sustaining treatment if you are later determined to be in a terminal condition and unable to decide for yourself.

• Terminal Condition Definition and Declaration (Nevada Revised Statutes Sections 449A.430, 449A.433)

  Nevada's terminal-condition definition is in NRS 449A.430: an incurable and irreversible condition that, without life-sustaining treatment, will result in death within a relatively short time in your attending physician's or advanced practice registered nurse's opinion. Nevada recognizes only this single trigger condition; there is no separate statutory permanent-unconsciousness or persistent-vegetative-state category.

• Pain Relief and Comfort Care Authorization (Nevada Revised Statutes Section 449A.451)

  The comfort-care provision is in NRS 449A.451(2): the declaration statute does not affect a provider's responsibility to treat for comfort or to alleviate pain, and Nevada's own statutory declaration form directs that treatment necessary for comfort or to alleviate pain is not to be withheld.

• Revocation Procedures (Nevada Revised Statutes Section 449A.445)

  You may revoke your declaration at any time and in any manner, regardless of your mental or physical condition. Revocation is effective once communicated to your attending physician or provider by you or a witness to the revocation.

• Pregnancy Limitations (Nevada Revised Statutes Section 449A.451)

  Life-sustaining treatment may not be withheld or withdrawn under your declaration while you are known to be pregnant, so long as it is probable the fetus will develop to the point of live birth with continued treatment.

• Healthcare Provider Immunity (Nevada Revised Statutes Section 449A.460)

  A physician or other provider who gives effect to your declaration in good faith, without knowledge of a revocation, is not subject to civil or criminal liability or professional discipline for doing so.

• Organ Donation Wishes (Nevada Revised Statutes Sections 451.500-451.598)

  Nevada's Revised Uniform Anatomical Gift Act (NRS 451.500-451.598) lets you document your wishes regarding organ donation.

• HIPAA Authorization (45 CFR Section 164.508)

  Federal HIPAA regulations govern how a person you authorize can access your protected health information in connection with your care.

• Patient Self-Determination Act Compliance (42 U.S.C. Section 1395cc(f))

  Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Nevada law to make an advance directive, including stating their own treatment wishes.

• Out-of-State Recognition (Nevada Revised Statutes Section 449A.481)

  Nevada's own declaration statute directly addresses out-of-state recognition. A declaration executed in another state, in compliance with that state's law or Nevada's, is valid for purposes of Nevada's Uniform Act on Rights of the Terminally Ill.

• Designation of a Substitute Decision-Maker Within the Declaration (Nevada Revised Statutes Section 449A.439)

  The statute lets you, inside the declaration itself, name a person and a backup to decide specifically about withholding or withdrawing life-sustaining treatment on your behalf if you become unable to decide, a narrower option than a full health care power of attorney.

• Definition of Terms (Nevada Revised Statutes Sections 449A.403-449A.430)

  Nevada law defines declaration, life-sustaining treatment, terminal condition, qualified patient, attending physician, and attending advanced practice registered nurse. Note that persistent vegetative state is not among the defined terms; only terminal condition is defined and used as a trigger.

• Guardianship Preferences (Nevada Revised Statutes Section 159.0613)

  Nevada law (NRS 159.0613) lets you express preferences for who should or should not be appointed as your guardian if court proceedings become necessary.

• Witness Requirements (Nevada Revised Statutes Section 449A.433)

  Your declaration must be signed by you, or by another adult at your direction, and attested by two witnesses. Nevada's declaration statute sets no qualification or disqualification requirements for who may serve as a witness, unlike many other states and unlike Nevada's own health care power of attorney statute, which excludes the owner, operator, or employee of a nursing home where the principal resides.

• Artificial Nutrition and Hydration Election (Nevada Revised Statutes Sections 449A.436, 449A.451)

  Nevada's optional statutory declaration form makes withholding or withdrawal of artificial nutrition and hydration the default once your declaration takes effect. You must separately initial a specific box on the form if you want to receive or continue receiving artificial nutrition and hydration after all other treatment is withheld.

• Separate Living-Will and Healthcare-Power-of-Attorney Statutes (Nevada Revised Statutes Sections 449A.400-449A.481, 162A.700-162A.870)

  Unlike states that combine both functions into one document, Nevada keeps its living-will declaration (NRS 449A.400 to 449A.481) and its durable power of attorney for health care (NRS 162A.700 to 162A.870) under two entirely separate statutes with two different execution rules. A durable power of attorney for health care that addresses withholding or withdrawing life-sustaining treatment also counts as a valid declaration under NRS 449A.433(3), but the two remain legally distinct instruments.