Vermont Living Will Requirements

Vermont does not have a legally separate living-will statute. Title 18, Chapter 231 creates one combined instrument, the Advance Directive, defined to include both treatment-wishes instructions and, optionally, appointment of a health care agent. The statute's own definitions confirm this combined instrument replaced what used to be two separate documents, a terminal care document and a durable power of attorney for health care.

Section 9701 defines an advance directive as a written record that may include appointment of an agent, a preferred clinician, instructions on health care desires or treatment goals, an anatomical gift, and disposition of remains. Vermont's own statute uses the term advance directive throughout, not living will; living will is the informal name for the treatment-wishes portion of that combined document.

You must be a competent adult, at least 18 years old, or an emancipated minor, to execute a valid Advance Directive.

The Advance Directive must be dated, signed by you or by another adult in your presence at your express direction if you are physically unable to sign, and signed by two or more adult witnesses who affirm you appeared to understand the document and were free from duress. Vermont has no notary alternative; witnessing is the only valid execution path.

Section 9702 lets your Advance Directive include appointment of a health care agent, including alternate agents, to decide for you when the directive takes effect. That is a separate function from the treatment-wishes instruction covered on this page: naming an agent gives someone else decision-making authority instead of stating your own wishes directly. For full agent-appointment guidance, see Vermont Healthcare Power of Attorney.

Your agent's authority has real limits. An agent may not consent to your voluntary sterilization, and your agent remains bound by whatever Vermont law provides regarding pregnancy and termination of pregnancy when acting on your behalf. These limitations apply to the agent-appointment side of your directive rather than the treatment-wishes instructions this page focuses on.

Your directive can spell out preferences about life-sustaining treatment, tube feeding, and comfort care for the time when you are close to death or unconscious and unlikely to regain consciousness. Vermont's own model form treats these as a single set of choices rather than separate mandatory elections, so one initialed decision can cover several treatments at once.

Vermont's model form frames this condition as being close to death rather than using a defined term like terminal condition. If you choose to limit treatment, you can specify which measures to withhold, including breathing machines, tube feeding, antibiotics, and other life-extending medications.

Your directive can separately address what happens if you become unconscious and are unlikely, to a reasonable degree of medical certainty, to regain consciousness. This is the second of the two conditions Vermont's own model form uses to frame the end-of-life election.

You can direct that pain medication be given even if it may have the unintended effect of hastening your death, and that you receive comfort care, dignity, and hospice care where appropriate, regardless of your other life-sustaining treatment choices.

Vermont treats revoking your treatment-wishes instructions differently from revoking your agent's authority. You can cancel your treatment instructions at any time and in any manner that shows your intent, including orally, in writing, or by another act. Canceling your agent's designation specifically requires a signed statement, personally telling your doctor, or physically destroying the directive.

Vermont does not automatically override or suspend your directive if you become pregnant. Instead, the state's own model form gives you a dedicated, separately initialed election to specify in advance exactly which life-sustaining treatments you want, or don't want, if it is determined you are pregnant when the directive becomes effective.

Your Advance Directive can include instructions on organ and tissue donation under Vermont's Uniform Anatomical Gift Act provisions, consistent with the organ donation section included in the state's own model form.

Federal HIPAA regulations govern how your health care agent can be authorized to access your protected health information once the agent-appointment portion of your directive is in effect. This authorization supports the agent-decision-maker side of your directive; it does not change your own treatment-wishes instructions.

Federal law requires Medicare and Medicaid participating facilities to inform you in writing of your right under Vermont law to make an advance directive, including stating your own treatment wishes.

Vermont recognizes an advance directive validly executed in another state or jurisdiction under that jurisdiction's own law, and presumes any directive executed under Vermont's chapter is valid. No third party may demand a different or additional form, and a photocopy or fax of a properly executed original carries the same weight as the original.

Vermont allows instructions on disposition of remains, burial or cremation preferences, and funeral goods and services to be included in the same Advance Directive as your health care instructions.

Vermont's model form points you to the Vermont Advance Directive Registry, administered under contract by the Vermont Ethics Network, and asks whether you want to register your directive with that free, voluntary service.

A witness to your Advance Directive cannot be your spouse, your agent, your parent, your adult sibling, your adult child, your adult grandchild, or your reciprocal beneficiary. Unlike many other states, Vermont law was changed specifically to allow your own health care provider or residential care provider, and their staff, to serve as witnesses.

If you are a current patient or resident of a hospital, nursing home, or residential care facility when you execute your Advance Directive, a third person must also sign, certifying that they explained the directive to you and that you appear to understand its nature and effect and are signing willingly and voluntarily. That person may be a hospital designee, a long-term care ombudsman, an attorney licensed to practice in Vermont, a clergyperson, or a Probate Division of the Superior Court designee.

Vermont law lets you add an optional provision to your Advance Directive, sometimes called a Ulysses Clause, authorizing your agent to consent to or refuse specific treatment even over your own objection at the time, once two clinicians determine you lack capacity. It requires naming your agent, your agent's written acceptance of that responsibility, your clinician's written confirmation that you understood the risks and benefits, and an independent person, such as an ombudsman, a mental health patient representative, or a Vermont-licensed attorney, confirming you understood the provision and were free from duress. You may revoke this specific provision only while you currently have capacity.

Separate from any court proceeding, you can use your own Advance Directive to record preferences for emergency involuntary mental health interventions and for electroconvulsive therapy, including which forms of ECT you consent to and any limit on the number of treatments. Vermont's own model form requires acknowledging the uniform informed consent procedures for ECT under 18 V.S.A. Section 7408.

Vermont's Patient Choice and Control at End of Life Act lets a qualified, mentally capable, terminally ill adult resident request medication to end their own life. This is a separate legal process from your Advance Directive: it requires your own contemporaneous, repeated request at the time, made while you still have capacity, and cannot be pre-authorized or elected in advance through your treatment-wishes instructions.