Pennsylvania: Health Care Power of Attorney Requirements
The short answer
A Pennsylvania health care power of attorney is valid if you (an adult of sound mind) date and sign it and two adults, each at least 18, witness it. No notary is required. By default your agent can act only after your attending physician determines you are incompetent, and the person you name cannot be your treating doctor or a caregiver at your facility unless they are related to you. If either you or your spouse files for divorce, your spouse is automatically dropped as your agent the day the case is filed.
Ask Ezel about your situation
This is the general rule in Pennsylvania. Ezel applies current Pennsylvania law to your specific facts and answers with citations to the statutes.
| Governing law & document | Advance Directive for Health Care Act (Act 169 of 2006), 20 Pa.C.S. Ch. 54, Subch. C (Health Care Agents and Representatives), §§ 5451–5465. A health care power of attorney may stand alone or be combined with a living will into an 'advance health care directive.' Any written form works (§ 5465); a sample combined form is in Subchapter D. No mandatory form. |
|---|---|
| Who can sign | An individual of sound mind who is 18 or older, has graduated from high school, has married, or is an emancipated minor. It must be dated and signed by the principal (signature or mark) — or by another person at the principal's direction if the principal cannot sign (§ 5452(a)–(b)). |
| Witnesses or notary | Two witnesses, each 18 or older, must witness it (§ 5452(b)(2)). No notarization is required — unlike Pennsylvania's separate financial power of attorney. There is no notary option or requirement in the statute. |
| Who can't witness or serve | A person who signed the document for the principal may not also witness it (§ 5452(c)(1)). Unless related to you by blood, marriage, or adoption, your health care agent may not be your attending physician or other health care provider, or an owner, operator, or employee of a health care provider where you are receiving care (§ 5455(b)). |
| When the agent can act | Springing by default. Unless the document says otherwise, it becomes operative when a copy is given to the attending physician and that physician determines the principal is incompetent, and it is inoperative whenever the physician finds the principal competent (§ 5454(a)–(b)). |
| Agent's powers & limits | Any health care decision and any power over the principal's care the principal could make, including facility admission; authority can extend past death for anatomical gifts, remains, and autopsies (§ 5456(a)). Limits: life-sustaining-treatment choices are subject to the pregnancy rule (§ 5429) and physician duties (§ 5462(a)); the agent cannot consent to care prohibited by Pennsylvania law or override its mental-health commitment consent laws (§ 5463(a)–(b)). |
| How to revoke | While of sound mind, revoke by a writing executed like the original (two witnesses, § 5452) or by personally informing your attending physician, health care provider, or agent (§ 5459(a)). Filing a divorce action revokes a spouse-agent as of the filing date, unless the directive clearly says the designation should survive (§ 5430). |
| Out-of-state directives | A health care power of attorney executed in another state in conformity with that state's laws is valid in Pennsylvania, except to the extent it would let the agent make a decision inconsistent with Pennsylvania law (§ 5464). |
Compare this rule across all 50 states + DC →
Pennsylvania's health care power of attorney lives in the Advance Directive for
Health Care Act — Chapter 54 of Title 20, added by Act 169 of 2006. A health
care power of attorney names another adult (your health care agent) to make
medical decisions for you when a physician determines you cannot. You can sign it
alone or combine it with a living will (your end-of-life treatment wishes) in
a single "advance health care directive." This page is about executing the
agent-appointment part; the rules are in Subchapter C, 20 Pa.C.S. §§ 5451–5465.
Requirements one by one
Governing law and document
A health care power of attorney is defined in § 5422 as "[a] writing made by a
principal designating an individual to make health care decisions for the
principal." Pennsylvania does not force you onto a particular form: under § 5465 a
health care power of attorney "may be in any written form identifying the
principal, appointing a health care agent and declaring that the principal
authorizes the health care agent to make health care decisions on behalf of the
principal." A sample combined directive appears in Subchapter D, but using it is
optional.
Who can sign
The capacity rule has an unusual second half. Under § 5452(a), the signer must be
"of sound mind" and fit one of four categories: 18 or older, a high school
graduate, married, or an emancipated minor. So a person under 18 who has finished
high school or married can execute one. The document must be "dated and signed by
the principal by signature or mark," or, if the principal cannot sign, "by another
individual on behalf of and at the direction of the principal" (§ 5452(b)(1)).
Witnesses or notary
Pennsylvania requires two witnesses and does not require a notary. Section
5452(b)(2) says the document must be "witnessed by two individuals, each of whom
is 18 years of age or older." That is the whole execution formality — there is no
notarization step. This is a genuine trap, because Pennsylvania's financial
power of attorney (a separate document under Chapter 56) has required both two
witnesses and notarization since 2015. The health care power of attorney does not.
Who can't witness or serve
The only witness bar is narrow: a person who signed the document for the principal
"may not witness the health care power of attorney" (§ 5452(c)(1)). Pennsylvania
does not otherwise disqualify relatives or the named agent from witnessing.
The limits on who may serve as agent are broader. Section 5455(b) provides
that "[u]nless related to the principal by blood, marriage or adoption," the agent
may not be "[t]he principal's attending physician or other health care provider"
or "[a]n owner, operator or employee of a health care provider in which the
principal is receiving care." A relative in one of those roles may still serve.
When the agent can act
By default the power is springing. Under § 5454(a), "[u]nless otherwise
specified," the document "becomes operative when: (1) a copy is provided to the
attending physician; and (2) the attending physician determines that the principal
is incompetent." It goes back to sleep whenever the physician determines you are
competent (§ 5454(b)). Because the trigger is only "[u]nless otherwise specified,"
you can write different terms into the document.
Agent's powers and limits
Once operative, § 5456(a) gives your agent "the authority to make any health care
decision and to exercise any right and power regarding the principal's care,
custody and health care treatment that the principal could have made and
exercised," including admitting you to a nursing or similar facility, and even
authority that extends past death to make anatomical gifts, dispose of remains,
and consent to autopsies. The main limits sit around life-sustaining treatment:
those decisions are "subject to" the pregnancy rule in § 5429 and the physician's
duties in § 5462(a) (§ 5456(b)). Separately, § 5463 preserves Pennsylvania's own
laws — the agent cannot consent to care "prohibited by the laws of this
Commonwealth" and the chapter does not override the state's mental-health
commitment consent rules.
How to revoke
While of sound mind, you may revoke "by a writing executed in accordance with the
provisions of section 5452" — that is, another two-witness document — "or by
personally informing the attending physician, health care provider or health care
agent that the health care power of attorney is revoked" (§ 5459(a)). A health
care provider may rely on the document until told of a revocation (§ 5459(b)).
Out-of-state directives
Section 5464 recognizes an out-of-state document: a health care power of attorney
"executed in another state or jurisdiction and in conformity with the laws of that
state or jurisdiction shall be considered valid in this Commonwealth" — with one
caveat, that it will not authorize your agent "to make a health care decision
inconsistent with the laws of this Commonwealth."
What trips people up
- A notary is not required — and does not substitute for the two witnesses.
People who know Pennsylvania's financial power of attorney must be notarized
often assume the medical one must be too. It must not; it needs two adult
witnesses (§ 5452(b)(2)). A notarized document with only one witness is not
validly executed. - Filing for divorce cancels a spouse-agent immediately. This surprises
almost everyone. Under § 5430, if your spouse is your health care agent and
"either spouse files an action in divorce, the designation of the spouse as
health care agent shall be revoked as of the time the action is filed" — the day
the case is filed, not when the divorce is final — unless the directive clearly
says the appointment should survive. Some published guidance wrongly says a
Pennsylvania health care directive is untouched by a divorce filing; § 5430 says
the opposite. Name an alternate agent, or sign a new directive. - Your treating doctor usually can't be your agent. Unless related to you, your
attending physician, another provider, or a facility's owner/operator/employee
where you are getting care cannot serve as your agent (§ 5455(b)). - "Sound mind" plus one of four boxes. A person under 18 can still make one if
they have finished high school, married, or are an emancipated minor (§ 5452(a)).
Common questions
Does a Pennsylvania health care power of attorney have to be notarized?
No. Two adult witnesses are the only execution formality (§ 5452(b)(2)).
Notarization is neither required nor a substitute for the witnesses.
Can my agent act while I still have capacity?
Not by default. The document becomes operative only when your attending physician
determines you are incompetent (§ 5454(a)). Because that default applies only
"[u]nless otherwise specified," you can write different terms into the document.
We just filed for divorce — is my spouse still my agent?
No, as of the filing date. Section 5430 revokes a spouse's designation the moment
either spouse files a divorce action, unless your directive clearly says it should
continue. Sign a new directive naming someone else.
Will the directive I signed in another state work in Pennsylvania?
Generally yes, if it was validly executed under that state's law, except that your
agent still cannot make a decision that Pennsylvania law forbids (§ 5464).
Statutes and sources
- 20 Pa.C.S. § 5422 — definitions ("health care power of attorney," "health
care agent," "advance health care directive").
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=22&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5452 — execution: who may make, dated and signed, two adult
witnesses, witness limits.
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=52&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5454 — when the power becomes operative (copy to physician;
physician's incompetence determination).
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=54&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5455 — who may not be appointed health care agent.
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=55&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5456 — authority of the health care agent and its limits.
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=56&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5459 — revocation (writing per § 5452, or informing physician,
provider, or agent).
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=59&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5430 — effect of divorce: a spouse-agent's designation is
revoked when a divorce action is filed.
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=30&subsctn=0 (accessed 2026-07-16) - 20 Pa.C.S. § 5464 — validity of a health care power of attorney executed in
another state.
https://www.palegis.us/statutes/consolidated/view-statute?txtType=HTM&ttl=20&div=0&chpt=54&sctn=64&subsctn=0 (accessed 2026-07-16)
Source links
Every statute quoted above, linked, with the date we checked it.
Get the answer for your situation
You just read how Pennsylvania handles this in general. Ezel applies current Pennsylvania law to your facts and answers your specific question, with citations.
Opens in Ezel Pro. Every answer cites the authority it relies on.