Health care directive in South Dakota: form, signing and who decides
The form, who can witness, who can be your agent and who decides if you have no directive in South Dakota.
Checked against official sources: October 31, 2026.
Short answer
Durable Power of Attorney for Health Care
- How to sign
- Notarized or signed by two adult witnesses
- Who decides without a directive
- Yes
The document and its form
- Document
- Durable Power of Attorney for Health Care
- Living will
Living Will Declaration
The living will is a separate document.
A living will tells your doctors about life-sustaining treatment if you are in a terminal condition, death is imminent and you can no longer communicate decisions. It must be signed by you (or by another at your direction) and witnessed by two adults or notarized, and it must state your wishes about artificial nutrition and hydration. A sample form is in the statute. If you have both a living will and a durable power of attorney, the later-signed document controls where they conflict.
Law: SDCL 34-12D-2, 34-12D-3, 34-12D-4, 34-12D-5
Signing rules
- How to sign
Sign the durable power of attorney for health care (or have someone sign for you in your conscious presence at your direction), then have the signature witnessed by two other adults or by a notary public. The health care power of attorney law refers to SDCL 59-12-3, which makes a power of attorney survive your disability when it contains words showing that intent.
- Who signs
Signed by you, or by another person you direct to sign your name in your conscious presence.
- Notary
- A notary or witnesses (your choice)
- Witnesses
- 2 (instead of a notary)
- Who cannot witness
Two other adults. The statute lists no other witness disqualifications.
Law: SDCL 59-7-2.1, 59-12-3
Who can be your agent and what the agent can do
- Who cannot be your agent
Any other person; the statute lists no exclusions.
Law: SDCL 59-7-2.1
- When the agent starts
The agent can decide whenever you lack capacity. The agent cannot decide when your attending physician has determined in good faith that you have decisional capacity.
Law: SDCL 59-7-2.1, 59-7-2.6
- Decisions an agent cannot make
The agent must follow accepted medical standards and consider the doctor's recommendation, what you would decide and your best interest. The agent cannot authorize withholding comfort care, and can authorize withholding artificial nutrition or hydration only in listed situations (for example if you said so in the document or expressly authorized it). Life-sustaining treatment and nutrition must be given to a pregnant woman except in limited cases.
Law: SDCL 59-7-2.5, 59-7-2.7, 59-7-2.8
Revoking and conflicting documents
- Revoking your agent
Chapter 59-7 does not set a specific method for revoking a health care power of attorney; a court's appointment of a guardian of your person ends it, though the guardian must follow your stated medical and end-of-life wishes.
Law: SDCL 59-7-11
- Revoking your instructions
You can revoke a living will at any time and in any manner, whatever your mental or physical condition. The revocation is effective when communicated to the health care provider, who must put it in your medical record.
Law: SDCL 34-12D-8
- Telling others
Tell your health care providers; a living will revocation takes effect when communicated to the provider.
- Conflicting documents
If you have both a living will and a durable power of attorney, the later-signed document controls to the extent they conflict.
Law: SDCL 34-12D-4
Law: SDCL 34-12D-8, 59-7-11
If you have no directive
- Who decides without a directive
If you have no durable power of attorney for health care or guardian of the person (or they are unavailable), health care decisions can be made by the first available person in this order. Before any court finding of incapacity, you can disqualify a family member in a signed document or by a note in your medical record made at your direction. A family member can delegate the decision to another family member in the same or a later class by a signed writing.
- Your spouse, if not legally separated
- An adult child
- A parent
- An adult sibling
- A grandparent or adult grandchild
- An adult aunt, uncle, cousin, niece or nephew
- A close friend
Law: SDCL 34-12C-3
Other states, registry and medical orders
- POLST (medical orders)
EMS Cardiopulmonary Resuscitation Directive
Law: SDCL ch. 34-12F
Free notice: revoke or change a health care directive
Free help in South Dakota
- East River Legal Services · 800-952-3015
- Dakota Plains Legal Services (via SD Law Help application)
- South Dakota UJS Self Help: Guardians and Conservators
- Find free legal aid at LawHelp.org
Report abuse or exploitation
Questions about powers of attorney in South Dakota
How do I sign a health care directive in South Dakota?
Sign the durable power of attorney for health care (or have someone sign for you in your conscious presence at your direction), then have the signature witnessed by two other adults or by a notary public. The health care power of attorney law refers to SDCL 59-12-3, which makes a power of attorney survive your disability when it contains words showing that intent.
Who decides my health care if I have no directive in South Dakota?
If you have no durable power of attorney for health care or guardian of the person (or they are unavailable), health care decisions can be made by the first available person in this order. Before any court finding of incapacity, you can disqualify a family member in a signed document or by a note in your medical record made at your direction.