Pennsylvania Living Will Requirements
Pennsylvania's living will is not a slice of some larger combined document the way many states structure this; it is its own separately titled law, the Living Will Act (20 Pa.C.S.
Introduction
Pennsylvania's living will is not a slice of some larger combined document the way many states structure this; it is its own separately titled law, the Living Will Act (20 Pa.C.S. Sections 5441-5447), sitting apart from the state's own separately titled Health Care Agents and Representatives Act that governs the health care power of attorney. A living will is your written statement of the medical treatment you want, or want withheld, if an incurable condition or permanent unconsciousness leaves you unable to speak for yourself, and Pennsylvania lets you sign one entirely on its own, naming no agent at all. Most people choose to combine the two into a single document instead, and Chapter 54 publishes an official example of exactly that combined form, but nothing in the law requires it. This guide covers the living will itself: the two conditions that activate it, how nutrition and hydration are handled as their own separate choice, the state's forceful pregnancy rule, and the execution mechanics, including the fact that Pennsylvania offers no notary alternative to the standard two-witness signing. Naming someone to decide what your instructions don't cover is a separate task the Pennsylvania Healthcare Power of Attorney page walks through on its own.
Key Things to Know
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Pennsylvania places surprisingly few restrictions on who may witness your living will. Unlike many states, there's no rule that a witness be unrelated to you, uninvolved in your estate, or disconnected from your health care provider. Your living will, governed by its own law (the Living Will Act, 20 Pa.C.S. Sections 5441-5447), is simply your written statement of the medical treatment you want or want withheld once you're determined incompetent and either have an end-stage medical condition or are permanently unconscious.
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A living will is not a last will and testament. A living will directs your medical treatment while you're alive but unable to communicate; a last will and testament decides who inherits your property after you die. Most people completing one for end-of-life planning eventually want the other too.
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Pennsylvania's living will lives under its own separately titled law, the Living Will Act, distinct from the law that governs the health care power of attorney. Pennsylvania also publishes an official example combining both into one document (Section 5471), the version most people actually sign, though it isn't required.
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Execution needs only your dated signature and two witnesses who are each 18 or older. Pennsylvania's living-will law provides no notary-acknowledgment alternative; witnessing is the only statutory route.
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Nutrition and hydration supplied by tube is its own separate, specifically initialed choice on Pennsylvania's official form, not folded into your general treatment wishes. Leave it unaddressed and state law presumes you'd want it continued, not withheld.
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Pennsylvania's pregnancy rule is unusually forceful. Life-sustaining treatment, nutrition, and hydration must still be given to a pregnant woman despite a contrary living will, unless her attending physician and an examining obstetrician both certify that continuing treatment won't permit a live birth, will physically harm her, or will cause pain medication can't manage.
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You can revoke your living will at any time, in any manner, regardless of your mental or physical condition, once you communicate that to your attending physician. Because a living will speaks for you directly rather than through anyone else, Pennsylvania lets you take it back just as directly, with no writing or witnessing required to undo it.
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Pennsylvania keeps no state registry for living wills or advance directives. There's nowhere to file yours with the Commonwealth; give copies directly to your physician, any health care agent you name, and close family.
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A living will validly signed in another state, under that state's own law, is recognized in Pennsylvania, except to the extent it would let you direct something Pennsylvania law itself does not allow.
Key decisions before you file
Before you file a Living Will in Pennsylvania, 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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Pennsylvania Requirements for Living Will
Pennsylvania's advance-directive framework sits in 20 Pa.C.S. Chapter 54, but it is not one single 'Advance Directive for Health Care Act.' Subchapter B has its own statutory short title, the Living Will Act (Section 5441), and Subchapter C has a separate short title, the Health Care Agents and Representatives Act (Section 5451). Each governs its own instrument with its own execution and revocation rules; Subchapter D (Section 5471) then provides an official example combining both.
Pennsylvania's statute does not use the term 'terminal condition.' The defined term is 'end-stage medical condition': an incurable and irreversible medical condition in an advanced state that will, to a reasonable degree of medical certainty, result in death despite continued medical treatment, with an express carve-out preserving treatment of unrelated, treatable conditions even if the person also has an end-stage condition.
Pennsylvania defines 'permanently unconscious' as a medical condition diagnosed, to a reasonable degree of medical certainty, as a total and irreversible loss of consciousness and capacity for interaction with the environment, expressly including an irreversible vegetative state or irreversible coma.
A living will may be made by an individual of sound mind who is 18 years of age or older, has graduated from high school, has married, or is an emancipated minor.
A living will must be witnessed by two individuals who are each 18 or older. Pennsylvania's disqualification list is narrower than many states': the only barred person is whoever signs the document on the principal's behalf (that person cannot also witness), and a treating health care provider or its agent may not act as that proxy signer. There is no requirement that a witness be unrelated to the principal, be free of any interest in the principal's estate, or not be the principal's own health care provider.
A living will 'may be in any written form' (Section 5447); there is no statutory requirement to address any specific treatment. Pennsylvania's own official example form (Section 5471) does address life-sustaining treatment generally, plus itemized choices for CPR, ventilation, dialysis, surgery, chemotherapy, radiation, and antibiotics, and treats tube-fed nutrition and hydration as a separate initialed choice.
A living will may, but need not, also designate a health care agent (Section 5447), at which point the agent's actual authority and duties are governed separately by Section 5456. Naming an agent is a separate function from stating your own treatment wishes; for full agent-designation guidance, see Pennsylvania Healthcare Power of Attorney.
This is not a provision requiring the living will to 'address' pregnancy wishes; it is a mandatory-treatment override. Life-sustaining treatment, nutrition, and hydration must be given to a pregnant woman who is incompetent and has an end-stage medical condition or is permanently unconscious, notwithstanding a contrary living will, unless her attending physician and an examining obstetrician both certify that continuing treatment will not permit continuing development and live birth, will be physically harmful to her, or will cause pain medication cannot alleviate.
A living will may be revoked at any time and in any manner by the principal, regardless of mental or physical condition. Revocation takes effect once communicated to the attending physician or other health care provider, who must then add it to the medical record.
Pennsylvania's Anatomical Gift Act provisions (Subchapter B of Chapter 86) let a person authorize donation of organs, tissue, or eyes by will or by a separate signed document, and Pennsylvania's own official living-will/combined-form example includes a dedicated anatomical-donation section.
Federal HIPAA regulations govern how a health care agent named alongside a living will may be authorized to access protected health information once the agent-designation portion of a combined directive is in effect; this does not change or expand the principal's own treatment-wishes instructions.
Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Pennsylvania law to make an advance directive, including stating their own treatment wishes in a living will.
A living will validly executed in another state or jurisdiction, in conformity with that jurisdiction's law, is considered valid in Pennsylvania, except to the extent it would allow a principal to direct procedures inconsistent with Pennsylvania law.
A health care provider or other person is protected from criminal and civil liability, professional discipline, and administrative sanction for good-faith compliance with a living will, a health care agent's or representative's decision, or a revocation made under Chapter 54, and likewise for good-faith refusal to comply on specific statutory grounds.
Pennsylvania's own official example living-will form (Section 5471) directs that the person be given treatment to relieve pain or provide comfort even if it might shorten life, suppress appetite or breathing, or be habit forming, regardless of the person's other life-sustaining-treatment choices.
Section 5460 lets a principal nominate a guardian of the person for consideration by a court, but the statute specifically ties this to a health care power of attorney, not to the living will itself, and also governs how a health care agent's authority relates to a later court-appointed guardian. This is agent-designation content; for full guardianship-interaction guidance, see Pennsylvania Healthcare Power of Attorney.
Section 8613 governs the manner of executing an anatomical gift, by will or by a separate signed document (witnessed, or recorded via a donor registry or driver's license), not specifically which organs may be donated or for what purposes (that is addressed at Section 8612). Both sit within the same Anatomical Gift Act subchapter Pennsylvania's official combined form cross-references.
Pennsylvania's living-will execution statute (Section 5442) provides only one valid path: a dated signature plus two witnesses who are each 18 or older. There is no notary-acknowledgment alternative anywhere in the Living Will Act, unlike states that let a person choose between notarization and witnessing. Someone who has their living will notarized but skips the two-witness signing has not validly executed it under Pennsylvania law.
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Check my Living WillFrequently Asked Questions
In Pennsylvania, a living will is its own legal document under the state's Living Will Act (20 Pa.C.S. Sections 5441-5447), separate from the health care power of attorney. It lets you state, directly and in writing, whether you want life-sustaining treatment initiated, continued, withheld, or withdrawn if your attending physician determines you're incompetent and either have an end-stage medical condition or are permanently unconscious. You can sign a Pennsylvania living will entirely on its own; naming a health care agent is optional, never required.
The two documents are governed by separate statutes, but the real difference is simpler than the citations: a living will states your own treatment wishes directly, in your own words, so your wishes control even before anyone else gets involved. A health care power of attorney instead names a person, an agent, to decide for you on whatever you haven't spelled out yourself. You can sign a Pennsylvania living will entirely on its own, naming no agent at all. Pennsylvania also publishes an official example combining both into one signed document, which most people actually use, but combining them is never mandatory. For the agent-designation side, see Pennsylvania Healthcare Power of Attorney.
They govern entirely different things at entirely different times. A Pennsylvania living will states your medical treatment wishes while you're alive but unable to communicate. A last will and testament decides who inherits your property after you die, and only takes effect at death. Signing one doesn't replace the other; most people handling end-of-life planning also want a Pennsylvania Last Will and Testament for their estate.
No, and there's no notary path offered at all. Pennsylvania's Living Will Act requires only your dated signature and two witnesses who are each 18 or older; notarization isn't available as an alternative execution route the way it is in some other states.
You should, even though the underlying statute doesn't force a specific form. Pennsylvania's own official example living will treats nutrition and hydration supplied by tube as its own initialed choice, apart from your general life-sustaining-treatment instruction, because state law presumes, absent your specific written instruction otherwise, that you'd want tube feeding continued rather than withheld.
Largely, no, and the override is stronger than in many states. Pennsylvania law requires life-sustaining treatment, nutrition, and hydration to keep being given to a pregnant woman who is incompetent and either has an end-stage medical condition or is permanently unconscious, regardless of a contrary living will, unless her attending physician and an examining obstetrician both certify that continuing treatment won't permit a live birth, will physically harm her, or will cause pain medication can't manage.
Fewer people than you might expect. Pennsylvania only disqualifies the person who signs the document on your behalf, if you can't sign yourself, from also serving as a witness, and it bars a treating health care provider from acting as that proxy signer. Unlike some states, there's no separate rule barring your relatives, heirs, or health care providers generally from serving as one of your two witnesses.
No. Pennsylvania operates no state registry for living wills or advance directives. Keep your signed original somewhere accessible, and give copies to your attending physician, any health care agent you name, and close family.
Yes. A living will validly executed under another state's law is considered valid in Pennsylvania, except to the extent it would let you direct something Pennsylvania law itself doesn't permit.