Hawaii: Health Care Power of Attorney Requirements

Hawaii's Uniform Health-Care Decisions Act (Modified), Haw. Rev. Stat.
chapter 327E, governs the appointment. The power of attorney for health care may
stand alone or appear as Part 1 of a combined advance health-care directive. The
sample form in § 327E-16 is optional.

Requirements one by one

Who can sign

An adult or emancipated minor may execute the power. It must be in writing,
contain its execution date, and be signed by the principal (§ 327E-3(b)). Hawaii
defines capacity as the ability to understand the significant benefits, risks,
and alternatives to proposed care and to make and communicate a decision
(§ 327E-2).

Witnesses or notary

The principal chooses one of two routes. The document may be signed or
acknowledged before at least two witnesses, or it may be acknowledged before
a notary public in Hawaii (§ 327E-3(b)). A notary replaces the witness route; it
is not required in addition to witnesses.

Who cannot witness or serve

No witness may be a health-care provider, an employee of a provider or facility,
or the named agent. If the principal uses two witnesses, at least one must be
both unrelated and not entitled to inherit from the principal (§ 327E-3(c)-(d)).

An agent generally cannot be an owner, operator, or employee of the institution
where the principal is receiving care. That agent bar does not apply when the
person is related to the principal by blood, marriage, or adoption
(§ 327E-3(b)).

When the agent can act

The default is springing authority. The agent begins only after the principal
lacks capacity and stops if capacity returns (§ 327E-3(e)). Unless the directive
chooses a different method, the primary physician makes that determination
(§ 327E-3(f)). The document may instead provide for immediate authority.

Powers and limits

The power may authorize the agent to make any health-care decision the principal
could make while having capacity (§ 327E-3(b)). The agent must follow the
principal's instructions and known wishes. If those are unknown, the agent uses
the principal's best interest and known personal values (§ 327E-3(g)). A decision
within that authority is effective without judicial approval (§ 327E-3(h)).

How to revoke

The agent designation has a specific rule: revoke it by signed writing or by
personally informing the supervising health-care provider (§ 327E-4(a)). Other
treatment instructions may be revoked in any manner that communicates intent,
but that broader rule does not replace the special agent-designation rule
(§ 327E-4(b)).

A decree of annulment, divorce, dissolution, or legal separation revokes a
spouse-agent unless the decree or power says otherwise (§ 327E-4(d)). A later
conflicting directive revokes the earlier one only to the extent of the conflict
(§ 327E-4(e)).

Out-of-state directives

Hawaii recognizes an advance directive if it complies with chapter 327E or if it
was executed in compliance with the law of the state where it was signed
(§ 327E-3(j)).

What trips people up

• Only one execution route is needed. Two qualified witnesses work without a
  notary, and a Hawaii notary works without witnesses (§ 327E-3(b)).
• The two witnesses need not both be disinterested. Both must avoid the
  provider/employee/agent bars, but only one must also be unrelated and not an
  heir (§ 327E-3(c)-(d)).
• Revoking the agent is narrower than revoking treatment instructions. A
  signed writing or personal notice to the supervising provider is required for
  the agent designation (§ 327E-4(a)).

Common questions

Do I need a notary if I use two witnesses?
No. Hawaii permits either two qualified witnesses or acknowledgment before a
notary (§ 327E-3(b)).

Can my adult child witness?
Possibly. A relative may be one witness if otherwise qualified, but at least one
of the two witnesses must be unrelated and not an heir (§ 327E-3(d)).

When can my agent start making decisions?
By default, after the primary physician determines you lack capacity, unless the
document provides otherwise (§ 327E-3(e)-(f)).

Will a directive signed in another state work?
Yes, if it complied with that state's execution law (§ 327E-3(j)).

Statutes and sources

• Haw. Rev. Stat. § 327E-3 — signing, witness-or-notary alternatives,
  witness and agent bars, effective time, authority, and out-of-state validity.
  https://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0327E/HRS_0327E-0003.htm
  (accessed 2026-07-16)
• Haw. Rev. Stat. § 327E-4 — revocation and spouse-agent rule.
  https://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0327E/HRS_0327E-0004.htm
  (accessed 2026-07-16)