New Jersey Living Will Requirements
New Jersey is one of the few states whose own advance-directive law lets you sign a living will that stands entirely on its own: the Advance Directives for Health Care Act calls it an 'instruction directive,' and you can execute one with no health care representative named at all, no agent, nothing beyond your own stated wishes.
Introduction
New Jersey is one of the few states whose own advance-directive law lets you sign a living will that stands entirely on its own: the Advance Directives for Health Care Act calls it an 'instruction directive,' and you can execute one with no health care representative named at all, no agent, nothing beyond your own stated wishes. This document, in plain terms, is your written statement of the medical treatment you want or want withheld once you can no longer speak for yourself, addressed directly to your physicians rather than routed through someone else's judgment. New Jersey's own Department of Health calls this an 'Instruction Directive (Living Will)' in its public guidance, so unlike some states, the phrase isn't just an outsider's shorthand for a legal concept the statute itself avoids naming. N.J.S.A. 26:2H-53 to 26:2H-78 lets you keep this instruction directive completely separate from a proxy directive, the document that names a health care representative, or combine the two, or execute the proxy directive alone instead; the choice, and the same signing rules either way, belong to you. This guide covers the instruction-directive side: how New Jersey's four-condition trigger list works, how artificial nutrition and hydration fits into your instructions, what New Jersey does and doesn't require about pregnancy, and how to execute the document validly. Naming a health care representative is a separate task the New Jersey Healthcare Power of Attorney page covers in its own right.
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Key Things to Know
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New Jersey names four specific conditions, not the usual two or three, under which your instruction directive can direct that life-sustaining treatment be withheld or withdrawn: futile or experimental treatment, permanent unconsciousness, a terminal condition, or a serious irreversible illness whose burdens outweigh its benefits. Your instruction directive is your own written statement of which treatments you want or refuse if you cannot speak for yourself; it does not name anyone to decide for you, that's a separate document under New Jersey law.
- 2
A living will is not a last will and testament. Your instruction directive 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 who complete one eventually want the other too.
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New Jersey does not build a fill-in-the-blank statutory form into the Advance Directives for Health Care Act itself. The state's Department of Health separately publishes a recommended instruction directive form you can use to put your own treatment wishes in writing.
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You can put your treatment wishes into effect by signing in front of two adult witnesses, or instead having your signature acknowledged before a notary public, an attorney at law, or any other person authorized to administer oaths. The only witness this declaration disqualifies is whoever you've named as your health care representative; your own physician or a nursing facility employee may still witness your wishes, unlike in some states.
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Artificial nutrition and hydration is covered automatically within your general treatment-wishes instruction. New Jersey's definition of life-sustaining treatment already includes artificially provided fluids and nutrition, so there's no separate line to initial.
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New Jersey does not impose an automatic pregnancy rule. A female declarant may choose to add her own instructions about what effect the directive should have if she becomes pregnant, but nothing changes by default if she says nothing.
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You can cancel or change your instructions at any time by telling your health care representative, physician, nurse, or another health care professional, orally or in writing, or by signing a new directive. Your change takes effect the moment you communicate it to anyone able to pass it along.
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New Jersey does not run a general registry for this directive. Keep your signed original with your physician, your health care representative, and people close to you rather than filing it with the state.
Key decisions before you file
Before you file a Living Will in New Jersey, 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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New Jersey Requirements for Living Will
Advance Directives for Health Care Act Compliance (N.J.S.A. 26:2H-53 to 78)
New Jersey's Advance Directives for Health Care Act defines an advance directive as a writing that may include a proxy directive, an instruction directive, or both. The instruction directive is the living-will function and is a legally sufficient document on its own, with no health care representative required. One execution section (N.J.S.A. 26:2H-56) governs the document regardless of which configuration a declarant chooses.
Sound Mind Attestation by Witnesses (N.J.S.A. 26:2H-56)
New Jersey law does not require the document itself to contain a separate declaration of the declarant's mental capacity. Instead, the two witnesses (if that execution path is used) must attest that the declarant is of sound mind and free of duress and undue influence at the time of signing.
Witness Requirements (N.J.S.A. 26:2H-56)
If you use witnesses instead of a notary or attorney, New Jersey requires two adult witnesses who attest you are of sound mind and free of duress and undue influence. New Jersey's ONLY witness disqualification is your designated health care representative. Unlike several other states, New Jersey's own Act does not disqualify your health care provider or an employee of a health care facility from witnessing.
Life-Sustaining Treatment Conditions (N.J.S.A. 26:2H-67)
N.J.S.A. 26:2H-67 names four conditions under which life-sustaining treatment may be withheld or withdrawn: treatment that is experimental, unproven, likely futile, or would merely prolong an imminent dying process; permanent unconsciousness confirmed by two physicians; a terminal condition confirmed by two physicians; or, if none of those apply, a serious irreversible illness whose risks and burdens reasonably outweigh its benefits, or where continuing treatment on an unwilling patient would be inhumane.
Comfort and Pain Relief Obligation (N.J.S.A. 26:2H-67(b))
Withholding or withdrawing life-sustaining treatment under a directive never relieves physicians, nurses, or other health care professionals of their obligation to provide for the patient's care and comfort and to alleviate pain, per N.J.S.A. 26:2H-67(b). This obligation for providers to ensure comfort and alleviate pain applies regardless of the treatment choices in your directive.
Optional Pregnancy Provision (N.J.S.A. 26:2H-56)
New Jersey does not impose an automatic rule changing, suspending, or voiding a directive during pregnancy. N.J.S.A. 26:2H-56 lets a female declarant optionally include her own instructions about what effect the directive should have if she is pregnant; if she says nothing on the subject, no default pregnancy rule applies.
Revocation Procedures (N.J.S.A. 26:2H-57)
A declarant may modify or revoke an instruction directive at any time by oral or written notification to a physician, nurse, or other health care professional, or by executing a subsequent directive. The change is effective as soon as it is communicated. Unlike some states, New Jersey does not apply a stricter revocation standard to the agent-designation piece than to the instruction directive; the same loose oral-or-written standard applies to both.
Organ Donation Wishes (N.J.S.A. 26:6-77 et seq.)
New Jersey's Revised Uniform Anatomical Gift Act (N.J.S.A. 26:6-77 et seq.) lets you state your wishes regarding organ and tissue donation, separately from your treatment-wishes instructions.
Religiously-Affiliated Institution Objection and Transfer Duty (N.J.S.A. 26:2H-65)
N.J.S.A. 26:2H-65 lets a private, religiously-affiliated health care institution adopt policies declining to participate in withholding or withdrawing specified life-sustaining measures. If that conflicts with your directive, the institution must attempt to resolve the conflict, and if it cannot, must take reasonable steps to transfer you promptly and respectfully to another institution.
Out-of-State and Foreign Recognition (N.J.S.A. 26:2H-77)
An advance directive validly executed under another state's law, in compliance with that state's law or New Jersey's, is valid in New Jersey. A directive executed in a foreign country under that country's law, or New Jersey's, is likewise valid here as long as it is not contrary to New Jersey public policy.
Patient Self-Determination Act Compliance (42 U.S.C. Section 1395cc(a)(1)(Q))
Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under New Jersey law to make an advance directive, including stating their own treatment wishes.
Experimental Treatment Provisions (N.J.S.A. 26:2H-67)
N.J.S.A. 26:2H-67(a)(1) expressly lets a declarant's instructions apply when life-sustaining treatment is experimental and not a proven therapy, or is likely to be ineffective or futile in prolonging life.
Standalone Instruction Directive Option (N.J.S.A. 26:2H-55, 26:2H-56)
Unlike states where the treatment-wishes declaration is only available as part of a combined directive, New Jersey's Advance Directives for Health Care Act separately defines and permits an 'instruction directive,' the living-will function, as a document a declarant may execute completely on its own, with no health care representative named. The same execution section (N.J.S.A. 26:2H-56) governs the instruction directive whether it stands alone or is combined with a proxy directive.
Psychiatric Advance Directive (PAD) Is a Separate Instrument (N.J.S.A. 26:2H-102 et seq.)
New Jersey's Advance Directive for Mental Health Care Act (N.J.S.A. 26:2H-102 et seq.) creates a distinct document, the Psychiatric Advance Directive (PAD), for stating psychiatric and mental health treatment preferences. This is a different statute from the general Advance Directives for Health Care Act covered on this page, has its own registry through the Division of Mental Health and Addiction Services, and is not something the general instruction directive covers.
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