West Virginia Living Will Requirements
West Virginia is unusual among the states in writing three complete, ready-to-sign forms directly into its own statute: you can execute a stand-alone Living Will, a stand-alone Medical Power of Attorney, or, since a 2022 amendment took effect, a single Combined document that does both at once.
Introduction
West Virginia is unusual among the states in writing three complete, ready-to-sign forms directly into its own statute: you can execute a stand-alone Living Will, a stand-alone Medical Power of Attorney, or, since a 2022 amendment took effect, a single Combined document that does both at once. Because West Virginia's Health Care Decisions Act actually defines "Living Will" as its own instrument and titles its own model form that name, signing the stand-alone version is a complete, freestanding declaration of the medical treatment you want, or don't want, if a physician certifies you have a terminal condition and you can no longer communicate. It names no one to decide for you; naming a representative is a separate task, whether through West Virginia's own Medical Power of Attorney or its Combined option. This guide covers the stand-alone Living Will: how West Virginia phrases the declaration, its single terminal-condition trigger, and the execution steps the statute actually requires. West Virginia's terminal-condition trigger needs certification from only one examining physician, a lighter bar than the two-physician requirement some other states impose. Whichever life-prolonging-intervention choice you make on the statutory form also automatically covers artificial nutrition and hydration; there's no separate line to initial for tube feeding on its own. And the state's Health Care Decisions Act stays silent on pregnancy altogether, meaning nothing in it changes how your directive applies if you become pregnant.
Key Things to Know
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West Virginia requires both a notary AND two witnesses on every Living Will, never a choice between the two. Your Living Will is your own written declaration of the medical treatment you want, or want withheld, if a physician certifies you have a terminal condition and you cannot communicate; it does not name anyone to decide on your behalf.
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A Living Will is not a Last Will and Testament. Your Living Will governs medical treatment while you are alive but unable to communicate; your Last Will and Testament controls who inherits your property after you die. West Virginia treats these as entirely separate documents with no shared execution rule.
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West Virginia's statute recognizes only one trigger condition, a certified terminal condition. Some states also trigger on permanent unconsciousness or a separate risk-versus-benefit standard; West Virginia's current Health Care Decisions Act does not.
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Only one examining physician's certification is needed to activate your Living Will in West Virginia. States sometimes require a second physician's confirmation; West Virginia's statutory form calls for just one.
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Artificial nutrition and hydration is never a separate initialed choice here. West Virginia's life-prolonging-intervention definition folds tube feeding and IV nutrition into the same single election as CPR, ventilator support, and dialysis.
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West Virginia's Health Care Decisions Act does not mention pregnancy anywhere. Your directive's effect does not change if you are pregnant.
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You may revoke your Living Will by destroying it, by delivering a signed written revocation to your attending physician, or by telling a witness who is 18 or older who signs a writing confirming it, once your physician is notified. There is no liability for anyone who acts on your directive without actual knowledge of a revocation.
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Your ordinary witnesses do not have to clear a health-care-facility-employee bar the way some states require; that restriction only applies to who may serve as a medical power of attorney representative, a role a stand-alone Living Will does not create.
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Filing your Living Will with West Virginia's voluntary e-Directive Registry, run by the West Virginia Center for End-of-Life Care, is optional. An unregistered, properly executed Living Will is still fully valid without it.
Key decisions before you file
Before you file a Living Will in West Virginia, 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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West Virginia Requirements for Living Will
West Virginia's Health Care Decisions Act lets any competent adult choose among three statutory paths: a stand-alone Living Will, a stand-alone Medical Power of Attorney, or a single Combined Medical Power of Attorney and Living Will, added by a 2022 amendment effective for documents executed on or after January 1, 2023. All three share identical execution rules under this same section.
The Living Will is created under the West Virginia Health Care Decisions Act, which gives individuals the right to make decisions about their own health care, including the right to accept or refuse medical treatment.
Any "competent adult" may execute a Living Will (Section 16-30-4(a)). "Adult" is defined at Section 16-30-3 as a person 18 or older, an emancipated minor, or a mature minor determined capable of making health care decisions; a "capable adult" is one physically and mentally capable of making health care decisions who is not a protected person under a court guardianship. The statutory form requires the signer to declare they are 'of sound mind'.
The Living Will must be signed in the presence of two witnesses at least 18 years old. Neither witness may be the person who signed on your behalf, related to you by blood or marriage, entitled to any part of your estate (unless the witness was unaware of that fact when witnessing), directly financially responsible for your medical care, your attending physician, or your medical power of attorney representative or successor representative. Both witnesses must independently clear this entire list; West Virginia does not carve out a health-care-facility-employee bar for ordinary witnesses the way some states do.
Notarization is not an optional add-on to witnessing. Section 16-30-4(a)(5) requires the two witnesses' own signatures and attestations to be acknowledged before a notary public in addition to their witnessing the principal's signature; this step and the two-witness requirement are cumulative, not alternatives. A Living Will signed only by two witnesses, without notarization, is not validly executed in West Virginia.
You may revoke your Living Will at any time by destroying the document, by delivering a signed and dated written revocation to your attending physician, or by verbally expressing your intent to revoke in front of a witness 18 or older who signs and dates a writing confirming it; the written or verbal methods take effect only once your attending physician receives notice. No one is liable for failing to honor a revocation they did not actually know about. If your Living Will is part of a Combined document and your representative is your spouse, a final divorce decree automatically revokes that spouse's designation.
"Terminal condition" means an incurable or irreversible condition, diagnosed by the attending physician or a qualified physician, for which the administration of life-prolonging intervention will serve only to prolong the dying process. This is West Virginia's only defined trigger condition for a Living Will; certification by a single examining physician is enough to establish it.
"Life-prolonging intervention" means any medical procedure that would artificially prolong the dying process, including, among other things, nutrition and hydration given intravenously or by feeding tube; it excludes medication or procedures necessary for comfort or pain relief. The statutory Living Will form's own list covers cardiopulmonary resuscitation, a breathing machine (ventilator), dialysis, and medically administered food and fluids as one bundled election.
West Virginia's definition of "life-prolonging intervention" expressly excludes medication or procedures necessary to provide comfort or alleviate pain, so comfort care is never something a Living Will can withhold. The statutory Living Will form itself states this directly: the signer wants to receive as much medication as necessary to alleviate pain, and oral food and fluids offered by spoon or straw continue if tolerated, regardless of the life-prolonging-intervention choice made.
If a Living Will conflicts with a POST form or with the decisions of a medical power of attorney representative or surrogate, the person's own expressed directives in the Living Will control. If two advance directives conflict with each other, the one most recently completed takes precedence, but only to the extent needed to resolve the inconsistency.
The Living Will may include provisions regarding organ and tissue donation, though West Virginia's Revised Anatomical Gift Act (Chapter 16, Article 19) separately governs anatomical gifts in more detail. The statutory Living Will form itself includes a place for special directives, which can include organ-donation wishes.
A living will, medical power of attorney, mental health advance directive, or similar medical orders form validly executed in another state is recognized in West Virginia if it complies with either West Virginia law or the law of the state where it was executed.
A physician, licensed health care professional, health care facility, or employee is not subject to criminal or civil liability for good-faith compliance with or reliance upon the directions in a Living Will, a POST form, or a medical power of attorney representative's or surrogate's decisions.
A health care facility is not required to change a published policy expressly based on sincerely held religious beliefs or moral convictions, and an individual provider may decline to honor a decision on the same grounds if they promptly notify the relevant parties; the representative or surrogate is then responsible for arranging a transfer, and the provider must cooperate.
West Virginia presumes consent to cardiopulmonary resuscitation in a cardiac or respiratory arrest unless a health care provider has actual knowledge of a DNR order, an effective Living Will or Combined document showing the person is in a terminal condition, an effective Medical Power of Attorney declining CPR, or a completed POST form ordering do-not-resuscitate.
A Physician Orders for Scope of Treatment (POST) form is a standardized, state-implemented order, required by statute to be printed on bright pink paper for quick recognition by emergency responders, reflecting a qualified physician's, advanced practice registered nurse's, or physician assistant's orders based on the person's wishes. It is a separate medical order coordinated with, not replacing, a Living Will.
Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to maintain written policies informing patients of their right under West Virginia law to make an advance directive, including a Living Will, and to document in the medical record whether the patient has executed one.
Does your Living Will need to be notarized in West Virginia?
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Check my Living WillFrequently Asked Questions
A Living Will in West Virginia is a stand-alone legal document, defined and governed by the West Virginia Health Care Decisions Act (West Virginia Code Chapter 16, Article 30), that lets you state directly whether you want life-prolonging intervention withheld or withdrawn if one physician certifies you have a terminal condition and you cannot communicate your wishes. Unlike some states where the term is only informal, West Virginia's statute literally defines "Living Will" and titles its own model form that name, so it is a complete document on its own, naming no one to decide for you.
In West Virginia these are two genuinely separate documents, though the same Health Care Decisions Act governs both. Your Living Will states your own treatment wishes directly, in your own words, for a certified terminal condition, with no one else's judgment involved. A Medical Power of Attorney instead hands that judgment call to someone else, a representative you name, rather than you stating the decision yourself in the document. You can sign either one alone, or use West Virginia's Combined form if you want both at once. For the representative-designation document, see West Virginia Healthcare Power of Attorney.
They control completely different things at completely different times. A West Virginia Living Will states your medical treatment wishes while you are alive but unable to communicate, triggered by a certified terminal condition. A Last Will and Testament says who inherits your property, and only takes legal effect after you die. Signing one does not replace the other; most people planning end-of-life medical wishes also want a separate West Virginia Last Will and Testament for their estate.
Both, with no alternative. West Virginia Code Section 16-30-4(a) requires you to sign in the presence of two witnesses at least 18 years old, and it separately requires those witnesses' own signatures to be acknowledged before a notary public. A Living Will signed only by witnesses, with no notary step, is not validly executed under West Virginia law.
Just one. West Virginia's statutory Living Will form triggers on certification by a single physician who has personally examined you. Some states require a second physician's confirmation before life-prolonging intervention can be withheld; West Virginia's form does not add that second step.
No. West Virginia's definition of "life-prolonging intervention" already includes nutrition and hydration given intravenously or by feeding tube, so whichever choice you make on the statutory terminal-condition declaration automatically covers it. There is no separate line to initial for tube feeding on its own, which can surprise people who have seen a different state's form split it out.
It doesn't. West Virginia's Health Care Decisions Act does not address pregnancy anywhere in the sections governing Living Wills, unlike a handful of other states that carve out a pregnancy exception. Your West Virginia directive keeps its full effect regardless of pregnancy status.
Under West Virginia Code Section 16-30-4(b), neither witness may be the person who signed the document on your behalf, related to you by blood or marriage, entitled to any part of your estate, directly financially responsible for your medical care, or your attending physician. Both of your witnesses must independently clear this list; West Virginia does not allow just one of the two to qualify while the other is related to you.
No. West Virginia operates a voluntary e-Directive Registry, run by the West Virginia Center for End-of-Life Care, where treating clinicians can look up a filed copy. Filing with it is entirely optional; a properly signed, witnessed, and notarized Living Will is fully valid whether or not you ever register it.