Health care directive in Hawaii: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in Hawaii.
Checked against official sources: October 31, 2026.
Short answer
Advance health-care directive (individual instruction and/or power of attorney for health care)
- Official form
- Advance Health-Care Directive - optional form
- How to sign
- Notarized or signed by two adult witnesses
- Who decides without a directive
- Yes
The document and its form
- Document
- Advance health-care directive (individual instruction and/or power of attorney for health care)
- Official form
- Advance Health-Care Directive - optional form (HRS 327E-16)Published by Hawaii State LegislatureVersion: Statutory optional form, HRS 327E-16 (HRS current through the January 2026 update)
You do not have to use it.
- Living will
Individual instruction
Part of the directive.
An individual instruction is your direction about health-care decisions. It can be oral or written, can take effect only if a condition arises, and can be included in a power of attorney for health care or in the optional form.
Law: HRS § 327E-16; HRS §§ 327E-2, 327E-3(a)
Signing rules
- How to sign
Sign and date the power of attorney for health care, then either have two qualified adult witnesses sign it or acknowledge it before a notary public in Hawaii. Individual instructions alone can be oral or written.
- Who signs
A power of attorney for health care must be in writing, dated and signed by you.
- Notary
- A notary or witnesses (your choice)
- Witnesses
- 2 (instead of a notary)
- Who cannot witness
Two witnesses who each saw you sign or saw you acknowledge your signature. A witness cannot be a health-care provider, an employee of a health-care provider or facility, or your agent. At least one witness must be neither related to you by blood, marriage or adoption nor entitled to any part of your estate under your will or by law. Instead of witnesses, you can acknowledge it before a notary public in Hawaii.
- Nursing facilities and special settings
Unless related to you by blood, marriage or adoption, your agent cannot be an owner, operator or employee of the health-care institution where you are receiving care.
Law: HRS § 327E-3(a)-(d)
Who can be your agent and what the agent can do
- Who cannot be your agent
Unless related to you by blood, marriage or adoption, your agent cannot be an owner, operator or employee of the health-care institution where you are receiving care.
Law: HRS 327E-3(b)
- When the agent starts
Unless the power of attorney says otherwise, the agent's authority starts only when your primary physician determines you lack capacity, and stops when the physician determines you have recovered capacity.
Law: HRS 327E-3(e), (f)
- Decisions an agent cannot make
The agent must follow your individual instructions and other known wishes, otherwise your best interest considering your personal values. Unless a court orders otherwise, a court-appointed guardian's health-care decision takes precedence over the agent's.
Law: HRS 327E-3(g); HRS 327E-6(b)
Revoking and conflicting documents
- Revoking your agent
You can revoke the designation of an agent only by a signed writing or by personally telling your supervising health-care provider. A decree of annulment, divorce, dissolution of marriage or legal separation revokes the designation of a spouse as agent, unless the decree or the power of attorney for health care says otherwise.
Law: HRS 327E-4(a); HRS 327E-4(d)
- Revoking your instructions
You can revoke all or part of the rest of an advance health-care directive at any time and in any manner that communicates your intent.
Law: HRS 327E-4(b)
- Telling others
A health-care provider, agent, guardian or surrogate who learns of a revocation must promptly tell your supervising health-care provider and any institution where you are receiving care.
Law: HRS 327E-4(c)
- Divorce ends a spouse's authority
- Yes · Divorce rules in Hawaii (Divorce Law Map)
- Conflicting documents
A later advance health-care directive revokes an earlier one to the extent they conflict.
Law: HRS 327E-4(e)
Law: HRS § 327E-4
If you have no directive
- Who decides without a directive
If your primary physician finds you lack capacity and you have no available agent or guardian, the physician must try to locate interested persons, who must try to agree on one surrogate: the person closest to you and most likely to know your current wishes. There is no ranked order. If they cannot agree, any of them may start a guardianship case. A surrogate you did not designate may withhold tube feeding or fluids only if two physicians certify the conditions in the law, and may not base life-sustaining decisions on a long-term disability or economic status.
- A surrogate you designated by personally telling your supervising health-care provider
- Otherwise, interested persons choose one surrogate by consensus: your spouse (unless legally separated or estranged), reciprocal beneficiary, any adult child, either parent, an adult sibling or adult grandchild, or any adult who has shown special care and concern and knows your values
Law: HRS §§ 327E-2, 327E-5
Other states, registry and medical orders
- Signed in another state
An advance health-care directive is valid if it complies with Hawaii's chapter or with the law of the state where it was signed.
Law: HRS 327E-3(j)
- POLST (medical orders)
Provider Orders for Life-Sustaining Treatment (POLST), form adopted by the Department of Health
- Mental health directive
You can make a written advance mental health care directive, alone or combined with an advance health-care directive, and name an agent for mental health decisions. It must be written, dated and signed, and either signed by two competent adult witnesses or acknowledged before a notary in Hawaii. Witnesses cannot be health care providers or their employees or relatives, owners, operators or employees of a facility where you are a patient or resident, your relatives, or your agent.
Law: HRS 327G-3
Law: HRS Chapter 327K
Free notice: revoke or change a health care directive
Free help in Hawaii
- Legal Aid Society of Hawaii
- Hawaii Revised Statutes Chapter 551E (Uniform Power of Attorney Act), official text
- Hawaii Revised Statutes Chapter 327E (Uniform Health-Care Decisions Act (Modified)), official text
- Find free legal aid at LawHelp.org
Report abuse or exploitation
Hawaii Department of Human Services - Adult Protective and Community Services Branch (Adult Protective Services) · (808) 832-5115
Questions about powers of attorney in Hawaii
How do I sign a health care directive in Hawaii?
Sign and date the power of attorney for health care, then either have two qualified adult witnesses sign it or acknowledge it before a notary public in Hawaii. Individual instructions alone can be oral or written.
Who decides my health care if I have no directive in Hawaii?
If your primary physician finds you lack capacity and you have no available agent or guardian, the physician must try to locate interested persons, who must try to agree on one surrogate: the person closest to you and most likely to know your current wishes.