Health care directive in the District of Columbia: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in the District of Columbia.
Checked against official sources: October 31, 2026.
Short answer
Durable power of attorney for health care
- Official form
- Durable power of attorney for health care
- How to sign
- Signed in front of two witnesses (no notary)
- Who decides without a directive
- Yes
The document and its form
- Document
- Durable power of attorney for health care
- Official form
- Durable power of attorney for health care (sample form in D.C. Code § 21-2207)Published by Council of the District of Columbia, D.C. Law LibraryVersion: Statutory sample form; any written form meeting § 21-2205 may be used
You do not have to use it.
- Living will
Declaration (Natural Death Act)
The living will is a separate document.
A declaration directs that life-sustaining procedures be withheld or withdrawn if two physicians, one your attending physician, certify that you have a terminal condition. Any person 18 or older can make one. It must be in writing, dated, and signed by you (or by another person in your presence at your express direction) in front of two witnesses 18 or older. A witness cannot be the person who signed for you, a relative by blood, marriage or domestic partnership, a person who would inherit from you, a person directly financially responsible for your medical care, your attending physician or the physician's employee, or an employee of the health facility where you are a patient. You must make sure your attending physician is told about it.
Law: D.C. Code § 21-2207; D.C. Code § 7-622
Signing rules
- How to sign
Sign and date the durable power of attorney for health care with two adult witnesses who also sign. A notary is not part of the statutory rule. The Natural Death Act declaration has its own, stricter witness rules.
- Who signs
Dated and signed by you (a competent adult). It must clearly say your attorney in fact may make health care decisions and include words such as 'This power of attorney shall not be affected by the subsequent incapacity of the principal' or 'This power of attorney becomes effective upon the incapacity of the principal.'
- Notary
- Not required
- Witnesses
- 2
- Who cannot witness
Two adult witnesses must sign and affirm you were of sound mind and free from duress. Neither witness can be you, your health care provider or an employee of your health care provider. At least one witness must not be related to you by blood, marriage or adoption and must not be entitled to any part of your estate under a current will or by law.
Law: D.C. Code § 21-2205(b)-(d)
Who can be your agent and what the agent can do
- When the agent starts
The attorney in fact can decide only when you are certified incapable of making or communicating a health care decision. Incapacity must be certified in writing by two District-licensed professionals, one a physician and one a qualified psychologist or psychiatrist; at least one must have examined you within one day before certifying. The attorney in fact cannot make a decision that you are able to make yourself.
Law: D.C. Code §§ 21-2204, 21-2205(a), 21-2206(b)(2)
- Decisions an agent cannot make
Subject to any limits you write, the attorney in fact has all your health care decision rights, including consenting to or refusing treatment, seeing your records, choosing providers and deciding admission or discharge from facilities. They must follow your wishes stated in the document, or, if unknown, act in good faith in your best interests.
Law: D.C. Code § 21-2206
Revoking and conflicting documents
- Revoking your agent
While you have capacity, you can revoke your attorney in fact's appointment by telling the attorney in fact orally or in writing, or revoke their authority by telling your health care provider orally or in writing. You are presumed to have capacity to revoke.
Law: D.C. Code § 21-2208(a), (c)
- Revoking your instructions
A Natural Death Act declaration can be revoked at any time, whatever your mental state, by destroying it (or having someone destroy it in your presence at your direction), by a signed and dated written revocation, or by saying you revoke it in front of a witness 18 or older who signs and dates a writing confirming it. A written or verbal revocation takes effect when it is communicated to your attending physician.
Law: D.C. Code § 7-624
- Telling others
A health care provider told of a revocation must note it in your records and make a reasonable effort to tell the attorney in fact. For a declaration, the attending physician records when the revocation was received.
Law: D.C. Code § 21-2208(b); § 7-624
- Divorce ends a spouse's authority
- Yes · Divorce rules in the District of Columbia (Divorce Law Map)
- Conflicting documents
Unless it says otherwise, a valid durable power of attorney for health care revokes any earlier durable power of attorney for health-care decisions.
Law: D.C. Code § 21-2208(d)
Law: D.C. Code §§ 21-2208, 7-624
If you have no directive
- Who decides without a directive
This list applies only when you have no durable power of attorney for health care and your incapacity has been certified. If no one in a higher group is reasonably available, mentally capable and willing, the next person decides. The order is a presumption: a lower-priority person who better knows your wishes can challenge a decision in Superior Court. At least one witness must be present when a family member or friend consents or refuses for you. The decision must follow your known wishes, or else your best interests. No one on this list can consent to abortion, sterilization, psycho-surgery, convulsive therapy or aversive behavior programs without a court order.
- A court-appointed guardian or conservator, within the scope of the appointment
- A court-appointed intellectual disability advocate, within the scope of the appointment
- Your spouse or domestic partner
- An adult child
- A parent
- An adult brother or sister
- Your religious superior, if you are a member of a religious order or a diocesan priest
- A close friend (not your treating provider or its owner, administrator or employee)
- Your nearest living relative
Law: D.C. Code §§ 21-2210, 21-2211
Other states, registry and medical orders
- POLST (medical orders)
Medical Orders for Scope of Treatment (MOST); electronic MOST (eMOST)
Law: D.C. Code §§ 21-2221.01 to 21-2221.15
Free notice: revoke or change a health care directive
Free help in the District of Columbia
- Probate Self-Help Center, D.C. Superior Court (515 Fifth Street NW, Room 314)
- D.C. Courts: Intervention Proceedings (adult guardianship and conservatorship)
- Find free legal aid at LawHelp.org
Report abuse or exploitation
Adult Protective Services, D.C. Department of Aging and Community Living (24-hour hotline) · 202-541-3950
Questions about powers of attorney in the District of Columbia
How do I sign a health care directive in the District of Columbia?
Sign and date the durable power of attorney for health care with two adult witnesses who also sign. A notary is not part of the statutory rule. The Natural Death Act declaration has its own, stricter witness rules.
Who decides my health care if I have no directive in the District of Columbia?
This list applies only when you have no durable power of attorney for health care and your incapacity has been certified. If no one in a higher group is reasonably available, mentally capable and willing, the next person decides.