Health Care Directive

A health care directive is a legal document that lets you (the “principal”) name a trusted person (your “health care agent”) to make medical decisions for you if you cannot speak for yourself. It also lets you write down your own wishes about medical treatment. Minnesota law governs health care directives under the Minnesota Health Care Directives Act ( Minn. Stat. Chapter 145C ).

This template creates a combined health care directive – it both names a health care agent and records your instructions about the care you want or do not want.

When to Use This Template

• Incapacity planning: You want someone you trust to make medical decisions if you become unable to communicate due to illness, injury, or age
• End-of-life planning: You want to put your wishes about life-sustaining treatment, comfort care, and other end-of-life decisions in writing
• Surgery or medical procedure: You are having a surgery or procedure and want to make sure your wishes are known in case of complications
• Chronic illness: You have been diagnosed with a serious illness and want to plan ahead for future medical decisions
• Estate planning: You are creating a comprehensive estate plan and want to make sure both your financial and medical wishes are documented

Types of Health Care Directives

Health Care Agent Appointment (Proxy Directive)

Names a person to make health care decisions on your behalf. This is sometimes called a “health care power of attorney.” Your agent steps in only when you cannot make or communicate your own decisions.

Living Will (Instruction Directive)

A written statement of your wishes about medical treatment. A living will tells your doctors what care you want or do not want if you are terminally ill or permanently unconscious. It does not name an agent.

Combined Directive (This Template)

This template combines both types into one document. It names a health care agent and records your treatment instructions. A combined directive is the most complete form of advance planning and is recommended for most people.

How to Use This Template

1. Download the template in your preferred format (PDF or DOCX).
2. Fill in your (the principal’s) full legal name, date of birth, and address.
3. Name your health care agent. Choose the person you trust most to make medical decisions for you. Include their full legal name, address, and phone number.
4. Name an alternate agent. This is a backup person who will serve if your first-choice agent is unable, unwilling, or unavailable. Include their full legal name, address, and phone number.
5. Write your health care instructions. State your wishes about life-sustaining treatment, tube feeding, pain management, organ donation, and any other medical care preferences.
6. Add any specific limitations on your agent’s authority. For example, you may want to require your agent to follow your written instructions strictly, or you may give your agent broad discretion.
7. Sign and execute the document. See the execution requirements below.

Powers You Can Grant Your Agent

Under Minnesota law ( Minn. Stat. § 145C.05 ), you can authorize your health care agent to:

• Consent to or refuse medical treatment – including surgery, medication, therapy, and diagnostic tests
• Make decisions about life-sustaining treatment – including ventilators, CPR, dialysis, and artificial nutrition and hydration
• Choose health care providers and facilities – select your doctors, hospitals, nursing homes, and other care settings
• Access your medical records – review, copy, and share your medical information as needed to make decisions
• Authorize organ and tissue donation – consent to donation after death
• Make decisions about mental health treatment – within the limits set by Minnesota law
• Arrange for comfort care and pain management – ensure you receive adequate pain relief and palliative care
• Make decisions about autopsy and disposition of remains – after death, if not addressed in other documents

Health Care Instructions You Can Include

Your directive can include specific instructions about the care you want or do not want. Common topics include:

• Life-sustaining treatment – whether you want CPR, mechanical ventilation, or other measures to keep you alive if you are terminally ill or permanently unconscious
• Tube feeding and IV fluids – whether you want artificial nutrition and hydration if you cannot eat or drink on your own
• Pain management – your preferences for pain relief, including whether you want maximum comfort care even if it may shorten your life
• Organ and tissue donation – whether you want to donate organs, tissues, or your body for medical research after death
• Mental health treatment – your preferences for psychiatric medication, electroconvulsive therapy, or admission to a mental health facility
• Specific medical conditions – instructions for specific situations, such as dementia, persistent vegetative state, or terminal cancer
• Religious or personal values – any beliefs or values that should guide your agent’s decisions
• Pregnancy – if applicable, whether your directive should apply during pregnancy

Choosing Your Health Care Agent

Qualities of a Good Agent

• Someone you trust completely to make medical decisions that reflect your values
• Someone who is willing to speak up to doctors and family members on your behalf, even in difficult situations
• Someone who knows your values and wishes about medical treatment and end-of-life care
• Someone who is available and can be reached quickly in an emergency
• Someone who can handle stress and make hard decisions under pressure
• Someone who will follow your instructions, even if they personally disagree with your choices

Agent’s Duties Under Minnesota Law

Your health care agent has a duty to ( Minn. Stat. § 145C.05 ):

• Make decisions that are consistent with your known wishes and instructions
• If your wishes are not known, make decisions that are in your best interest
• Act in good faith
• Make decisions only when you are unable to make or communicate your own health care decisions
• Follow any limitations you placed on their authority in the directive

An agent who acts in good faith is not subject to civil or criminal liability for health care decisions made under the directive.

Revoking a Health Care Directive

You can revoke (cancel) your health care directive at any time, regardless of your mental or physical condition ( Minn. Stat. § 145C.04 ). You can revoke by:

1. Signing a written revocation – a signed, dated statement that you revoke the directive
2. Making an oral statement – telling a health care provider or any other person, in the presence of a witness, that you revoke the directive
3. Destroying the document – tearing up, burning, or otherwise destroying the original directive
4. Creating a new directive – a new health care directive automatically revokes any prior directive to the extent they conflict

You do not need to be mentally competent to revoke a health care directive. Minnesota law allows revocation even by a principal who may lack capacity in other areas, reflecting the strong public policy favoring a person’s right to control their own medical decisions.

Relationship to Financial Power of Attorney

Provider Duties

Health care providers who receive a copy of your directive have legal obligations under Minnesota law ( Minn. Stat. § 145C.06 ):

• Must comply – a provider must make a good-faith effort to follow the instructions in your directive and the decisions of your health care agent
• Must include in your records – the provider must place a copy of the directive in your medical file
• Moral or religious objection – if a provider cannot follow your directive because of sincerely held moral or religious beliefs, the provider must inform you or your agent promptly and must make reasonable efforts to transfer your care to a provider who will comply
• Cannot require a directive – a provider cannot require you to have a health care directive as a condition of providing care or insurance coverage
• Immunity – a provider who follows a valid directive in good faith is not subject to civil or criminal liability for carrying out the patient’s wishes

Minnesota’s Suggested Statutory Form

Minnesota law ( Minn. Stat. § 145C.16 ) provides a suggested statutory form for health care directives. This template follows that suggested form. Using the statutory form is not required, but it is widely recognized by health care providers and institutions across Minnesota.

You are not limited to the statutory form. You can customize your directive to address your specific situation, as long as it meets the execution requirements under Minn. Stat. § 145C.03 .

Common Mistakes to Avoid

1. Not executing the document properly. Your directive must be signed and either notarized or witnessed by two qualifying witnesses. Without proper execution, the directive is not valid.
2. Having your health care agent serve as a witness. Minnesota law prohibits the named agent from serving as a witness to the directive.
3. Not talking to your agent about your wishes. A written directive is important, but it cannot cover every possible medical situation. Talk to your agent about your values, beliefs, and preferences so they can make informed decisions.
4. Not giving copies to the right people. Give copies to your agent, alternate agent, primary care doctor, any specialists who treat you regularly, and your local hospital. Bring a copy when you are admitted to a hospital or care facility.
5. Confusing a health care directive with a financial power of attorney. A health care directive does not cover financial decisions. You need a separate financial power of attorney for that.
6. Not updating the directive when circumstances change. Review your directive if you get divorced (especially if your former spouse is your agent), if your agent dies or becomes unable to serve, if your health changes significantly, or if your wishes change.
7. Storing the directive where no one can find it. A safe deposit box that only you can access is a poor choice. Keep the original in a safe but accessible place and tell your agent and family where it is.
8. Assuming your family will automatically be able to make decisions. Without a health care directive, there is no guarantee that your preferred person will make your medical decisions. Minnesota law provides a default list of decision-makers, but a directive ensures your chosen person has authority.

Related Resources

• Minnesota Board on Aging – advance care planning resources and assistance for older Minnesotans
• Minnesota Attorney General - Health Care Directives – consumer information about advance directives
• Minnesota Department of Health – health care information and resources
• Honoring Choices Minnesota – free facilitated conversations and resources for advance care planning