Tennessee Living Will Requirements
Tennessee's own Advance Directive for Health Care form says outright that its two parts, naming an agent and stating your own treatment wishes, 'may be used together or independently': you can complete only the treatment-wishes half and mark out the rest, which is exactly what a living will does.
Introduction
Tennessee's own Advance Directive for Health Care form says outright that its two parts, naming an agent and stating your own treatment wishes, 'may be used together or independently': you can complete only the treatment-wishes half and mark out the rest, which is exactly what a living will does. This document, most people's shorthand for that treatment-wishes half, is your written statement of the medical care you want or want withheld once you can no longer speak for yourself. Tennessee's current guidance channels most people toward this one combined form, adopted by the Board for Licensing Health Care Facilities and effective May 9, 2017, though an older, genuinely separate law, the Tennessee Right to Natural Death Act, still exists and remains valid for anyone who already executed a living will under it. This guide covers the treatment-wishes side: how Tennessee frames the choices, how to sign it validly, and how it differs from naming a health care agent, a separate task the Tennessee Healthcare Power of Attorney page covers on its own.
Key Things to Know
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Tennessee's treatment-wishes declaration needs only one of two execution methods, two witnesses or a notary public, not both; the agent-designation half of this same official form requires a notary and two witnesses together, a stricter rule that applies only to naming an agent, not to your own instructions.
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This document is Part 2 of Tennessee's official Advance Directive for Health Care form, the treatment-wishes portion. The form's own instructions say Part 2 may be completed on its own, without naming any agent in Part 1 at all.
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A living will is not a last will and testament. A living will covers medical treatment while you are alive but unable to communicate; a last will and testament covers who inherits your property after you die. Most people completing one eventually want the other too.
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Tennessee no longer points people toward a freestanding 'living will' form in current practice. Its combined Advance Directive for Health Care, adopted by the Board for Licensing Health Care Facilities effective May 9, 2017, replaced the older separate forms, though the older Right to Natural Death Act remains valid law for anyone who already signed under it.
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Artificial nutrition and hydration gets its own separate yes or no line on Tennessee's form, distinct from the general life-support choice. Marking one does not automatically answer the other.
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Tennessee law includes no clause suspending or changing your directive if you become pregnant.
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Unlike some states, Tennessee does not bar your own physician or a health care facility employee from serving as a witness to your directive. The only people excluded are your named agent and, for one of your two witnesses, a close relative who would inherit from you.
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Tennessee keeps no state registry for advance directives and has no special extra-witness requirement for skilled nursing facility residents. Give copies directly to your physician and your named agent instead.
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Revoking these treatment-wishes instructions only takes communicating that intent while you have capacity, an easier bar than revoking your agent's authority, which the Tennessee Healthcare Power of Attorney page covers separately.
Key decisions before you file
Before you file a Living Will in Tennessee, 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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Tennessee Requirements for Living Will
Tennessee's Health Care Decisions Act (T.C.A. Title 68, Chapter 11, Part 18, Sections 68-11-1801 et seq.) creates the legal framework for the state's current combined Advance Directive for Health Care, which bundles agent designation and treatment-wishes instructions into one form usable together or independently. An older, separate living-will-only statute, the Right to Natural Death Act (Title 32, Chapter 11), remains valid too and is expressly preserved by Section 68-11-1803(j).
A full advance directive for health care must be in writing and signed by you. A more limited oral 'individual instruction,' a direction about a single health care decision, does not have to be written at all under Section 68-11-1803(a); the written-and-witnessed rule applies to the complete advance directive document, not to every wish you communicate orally to your doctor.
Tennessee law defines capacity as the ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health care decision (Section 68-11-1802(a)(3)). To execute an advance directive you must be an adult or an emancipated minor (Section 68-11-1803(b)); the statute itself does not use a separate 'sound mind' standard.
If you use witnesses instead of a notary, Tennessee requires two competent adult witnesses who are not your named agent. At least one of the two must not be related to you by blood, marriage, or adoption and must not be entitled to any portion of your estate. Unlike some states, Tennessee's witness rule does not exclude your own health care provider, that provider's employees, or a care facility operator or employee from serving as a witness.
Acknowledging your directive before a notary public is an equally valid path, not a fallback for people who cannot find witnesses. Tennessee treats notarization and two-witness signing as two independently sufficient, co-equal ways to execute a valid directive.
Tennessee treats revoking your treatment-wishes instructions differently from revoking your agent's authority, and both require you to have capacity. You may revoke your instructions at any time and in any manner that communicates your intent, while you have capacity. Revoking your agent's designation requires a signed writing or personally informing your supervising health care provider.
'Terminal condition' is not a term Section 68-11-1802 defines; that definition actually lives in the older, separate Right to Natural Death Act at T.C.A. Section 32-11-103, which remains valid law. Tennessee's current official Advance Directive for Health Care form instead uses its own four quality-of-life categories, Permanent Unconscious Condition, Permanent Confusion, Dependent in all Activities of Daily Living, and End-Stage Illnesses, as the trigger conditions for withholding or withdrawing treatment.
Section 68-11-1802's list of defined terms does not include 'permanent unconsciousness.' Permanent Unconscious Condition is instead one of four quality-of-life categories on Tennessee's current official Advance Directive for Health Care form, issued by the Board for Licensing Health Care Facilities under Section 68-11-1805, and is described there as becoming totally unaware of people or surroundings with little chance of ever waking from the coma.
Tennessee's current official form asks you to address CPR, general life support, treatment of new conditions, and artificial nutrition and hydration as four separate yes or no lines rather than one combined choice. Artificial nutrition and hydration in particular gets its own line, labeled Tube feeding/IV fluids, distinct from the general life-support line; marking one does not decide the other.
Tennessee's Revised Uniform Anatomical Gift Act (T.C.A. Title 68, Chapter 30, Part 1, Sections 68-30-101 to 68-30-120) lets you authorize organ and tissue donation, and Tennessee's own official Advance Directive for Health Care form includes a dedicated organ-donation section alongside its treatment-wishes and agent-designation parts.
Federal HIPAA regulations (45 CFR Section 164.508) govern how your health care agent can access your protected health information once the agent-designation part of your directive is in effect. This authorization supports the agent-decision-maker function; it does not expand your own treatment-wishes instructions.
An advance directive executed outside Tennessee by a nonresident of Tennessee at the time of execution is given effect in Tennessee if it complies with either Tennessee's Health Care Decisions Act or the law of the state where the person resided. An advance directive executed by a Tennessee resident should follow Tennessee's execution rules, even if signed while temporarily out of state.
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 discipline for unprofessional conduct, for complying with a health care decision, for declining to comply based on a reasonable belief the person lacked authority, or for complying with an advance directive reasonably believed valid and unrevoked.
A health care provider may decline to comply with your instructions for reasons of conscience, or if the instructions require medically inappropriate care or care contrary to generally accepted health care standards. A provider who declines must promptly say so, keep providing care until a transfer can happen, and make reasonable efforts to transfer you to a provider or institution willing to comply.
Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Tennessee law to make an advance directive, including stating their own treatment wishes.
Tennessee's Declarations for Mental Health Treatment law (T.C.A. Title 33, Chapter 6, Part 10, Sections 33-6-1001 to 1015) is a separate statute that lets a competent adult document preferences about psychiatric hospitalization, medication, and convulsive therapy. It is its own document with its own signature and witness rules, cannot be signed on the premises of a mental health provider, and is not part of the Advance Directive for Health Care covered on this page, though it may be incorporated into a Tennessee durable power of attorney for health care.
Tennessee's older Right to Natural Death Act separately defines palliative care as comfort measures, including sedatives, pain medication, oral feeding, suction, hydration, and hygiene care, that remain available regardless of the life-sustaining treatment choices you make elsewhere in your directive.
If you have not named an agent, have no guardian, and none is reasonably available, Tennessee identifies a surrogate decision-maker in descending order of preference: your spouse unless legally separated, an adult child, a parent, an adult sibling, another adult relative, or another qualified adult who has shown special care and concern for you.
Tennessee's official Advance Directive for Health Care form, adopted by the Board for Licensing Health Care Facilities under Section 68-11-1805, states outright that its Part 1 (agent designation) and Part 2 (treatment-wishes instructions) may be used together or independently, with instructions to mark out or void any unused part. A person can validly complete only the living-will/treatment-wishes portion of the state's combined form without naming any health care agent at all.
Frequently Asked Questions
In Tennessee, a living will is the treatment-wishes portion of the state's Advance Directive for Health Care, the combined form the Board for Licensing Health Care Facilities adopted in 2017. The form's own instructions say its agent-naming part and its treatment-wishes part may be completed together or independently, so filling out only the treatment-wishes portion, marking which conditions you would find unacceptable and what care you do or don't want, is exactly what a Tennessee living will does. An older, separate Tennessee statute, the Right to Natural Death Act, also still exists for anyone who executed a declaration under it before the newer form took over.
Tennessee's current Advance Directive for Health Care has two parts you can use together or separately. Part 1 names a health care agent, the power-of-attorney function, someone who decides for you on matters your instructions don't cover. Part 2 is the living will function, where you state your own wishes directly with no agent involved. You are free to complete only Part 2. For the agent-naming side specifically, see Tennessee Healthcare Power of Attorney.
They govern different things at different times. A Tennessee living will 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 effect at death. Signing one does not replace the other; most people planning for incapacity also want a separate Tennessee Last Will and Testament for their estate.
Yes, mark it separately. Tennessee's official form gives tube feeding and IV fluids their own yes or no line, distinct from the general Life Support / Other Artificial Support choice. Marking one does not decide the other, so if you want to address artificial nutrition and hydration specifically, mark that line on its own; leaving it blank will not carry over your answer from the general life-support question.
No. Nothing in Tennessee's Health Care Decisions Act or its older Right to Natural Death Act suspends, voids, or modifies a living will because the declarant is pregnant. Some other states carve out a pregnancy exception; Tennessee's statutes contain no such clause.
Yes, generally. Tennessee's witness rule excludes only your named health care agent and, for at least one of your two witnesses, a close relative who stands to inherit from you. Unlike some states, it does not disqualify your own physician, that physician's employees, or a care facility operator or employee from serving as a witness.
No. Tennessee keeps no advance directive registry of any kind. Give a copy directly to your physician, keep one in your own files, and give one to whomever you have named as your health care agent; that is the state's own recommended practice, not registration with any government office.
A living will properly executed before July 1, 2004 under the old Tennessee Right to Natural Death Act remains valid and will be honored; you do not need to redo it. For anyone executing a new advance directive today, though, Tennessee's own guidance points to the current combined Advance Directive for Health Care form adopted in 2017.