Living Will and Advance Health-Care Instruction Requirements in Louisiana
At a glance
| Governing law and document | La. R.S. 40:1151.1–1151.9: a 'declaration' authorizing withholding/withdrawal of life-sustaining procedures. It may be written, oral, or nonverbal under separate routes (§§ 40:1151.1–.2). The § 40:1151.2(C) form is illustrative, not mandatory, and may include other specific directions or a narrow treatment decision-maker designation. |
|---|---|
| Who may make an instruction | Any adult person; this Subpart defines a minor as under 18 (§§ 40:1151.1, .2). Written declaration may be made at any time. Oral/nonverbal route is available only after diagnosis of a terminal and irreversible condition (§ 40:1151.2). The declarant personally signs the written route. |
| Oral, written, and signature form | Written route: declarant personally signs in 2 witnesses' presence; no mandatory date in the operative rule, though the optional form is dated (§ 40:1151.2(A),(C)). Oral/nonverbal route: any nonwritten communication after diagnosis, in 2 witnesses' presence (§ 40:1151.2(A)(3)). Physician records why a written declaration could not be made (§ 40:1151.2(B)(4)). |
| Witness, notary, and disqualifications | 2 witnesses for written and oral/nonverbal routes (§ 40:1151.2). Each is a competent adult, unrelated by blood or marriage, and not entitled to any part of the declarant's estate (§ 40:1151.1(15)). No notary alternative or additional facility-witness rule is stated. |
| Covered conditions and trigger | A 'qualified patient' has a terminal and irreversible condition diagnosed and certified in writing by 2 physicians who personally examined the patient, 1 the attending physician (§ 40:1151.1(11)). Condition means continual profound coma with no reasonable recovery chance, or injury/disease/illness expected to produce death where life-sustaining procedures only postpone death (§ 40:1151.1(14)). No separate incapacity finding is required for the adult's own declaration. |
| Treatment, nutrition, hydration, and comfort | May authorize withholding/withdrawal of life-sustaining procedures, defined to include invasive nutrition/hydration and CPR but exclude measures necessary for comfort (§ 40:1151.1). Illustrative form separately chooses withdrawal of all procedures including nutrition/hydration or withdrawal except nutrition/hydration, and directs natural dying with comfort medication/procedures (§ 40:1151.2(C)). |
| Pregnancy and other statutory limits | Not blanket suspension. Any ambiguity is interpreted to preserve life, including unborn life, if an obstetrician finds probable postfertilization age 20+ weeks and the pregnant qualified patient's life can reasonably be maintained for continued development/live birth, with the finding communicated to listed family/designees (§ 40:1151.9(E)). Subpart does not authorize assistance to suicide, mercy killing, euthanasia, or another affirmative/deliberate act or omission to end life beyond natural dying (§ 40:1151.9(A)). |
| Revocation, notice, and registry | Revoke anytime regardless of mental state/competency by directed destruction, signed dated writing, or oral/nonverbal expression; effective on communication to attending physician, who records notice time/date (§ 40:1151.3(A)). Optional Secretary of State registry accepts originals/multiple originals/certified copies; registered directive needs written revocation notice filed there, with $20 registration and $5 revocation fees (§§ 40:1151.2(D), .3(B)). |
| Provider duties, recognition, and effect | Notified attending physician obtains written two-physician certification; physician refusal requires reasonable transfer effort, and facility policy refusal requires all reasonable transfer steps (§ 40:1151.6). No registry-search duty. Good-faith statutory withholding/withdrawal receives immunity and a compliant declaration is presumed voluntary (§ 40:1151.7). A declaration properly executed under another state's law is deemed validly executed (§ 40:1151.9(D)). |
Louisiana's declaration statute covers an adult's instruction to withhold or withdraw life-sustaining procedures after a terminal and irreversible condition. It offers a written advance-planning route and a narrower oral-or-nonverbal route after diagnosis. This page excludes surrogate declarations, broad health-care mandates, and clinician orders.
Requirements one by one
Written and nonwritten routes have different timing
Under § 40:1151.2(A), an adult may make a written declaration at any time by personally signing in the presence of two witnesses. The operative rule does not require a date, although the optional form contains one. An oral or nonverbal declaration also needs two witnesses but is available only after diagnosis of a terminal and irreversible condition. The physician records why the adult could not make a written declaration.
Each witness is a competent adult, unrelated by blood or marriage, and not entitled to any part of the declarant's estate under § 40:1151.1(15). The Subpart does not substitute notarization for the two witnesses. Its printed form is illustrative rather than mandatory and may be supplemented.
Two physicians certify one defined condition
A qualified patient must be diagnosed and certified in writing by two physicians who personally examined the patient, one the attending physician. Under § 40:1151.1(14), the terminal and irreversible condition is either a continual profound coma with no reasonable chance of recovery or an injury, disease, or illness expected to produce death where life-sustaining procedures would only postpone death. The adult's own declaration does not require a separate incapacity certification.
Nutrition, hydration, CPR, and comfort are expressly separated
Section 40:1151.1(8) includes invasive nutrition and hydration and CPR in the definition of life-sustaining procedure, while excluding measures necessary for comfort care. The illustrative form in § 40:1151.2(C) separately offers withdrawal of all life-sustaining procedures including invasive food and water, or withdrawal except nutrition and hydration. It directs natural dying with medication and procedures necessary for comfort.
Pregnancy uses a 20-week ambiguity rule
Louisiana does not state blanket suspension throughout pregnancy. Instead, § 40:1151.9(E) requires an ambiguity to be interpreted to preserve life, including unborn life, if an examining obstetrician finds both a probable postfertilization age of at least 20 weeks and that the qualified patient's life can reasonably be maintained to permit continued development and live birth. The finding must be communicated to the statutory family and designated-person classes.
Section 40:1151.9(A) separately says the Subpart does not authorize assistance to suicide, mercy killing, euthanasia, or another affirmative or deliberate act or omission to end life beyond natural dying.
Revocation is broad, but notice controls effectiveness
Under § 40:1151.3, the adult may revoke at any time regardless of mental state or competency by directed destruction in the adult's presence, signed and dated writing, or oral or nonverbal expression. Any method becomes effective when communicated to the attending physician, who records the notice time and date.
The optional Secretary of State registry accepts an original, multiple original, or certified copy under § 40:1151.2(D). A registered declaration also needs written revocation notice filed there; until the office notes it, a physician or facility may rely on it in good faith. The statute permits a $20 registration fee and $5 revocation-notice fee.
Refusal requires transfer efforts
Once notified, the attending physician takes the steps needed for written certification. Under § 40:1151.6, a refusing physician makes a reasonable effort to transfer the patient; a facility whose policy prevents compliance takes all reasonable transfer steps. Neither physician nor facility has a duty to search the registry.
Good-faith compliance receives the immunity in § 40:1151.7, and a compliant declaration is presumed voluntary. A declaration properly executed under another state's laws is deemed validly executed under § 40:1151.9(D).
What trips people up
- Oral instructions are post-diagnosis only. The written route is available at any time.
- A notary does not replace the witnesses. Both adult routes use two disinterested witnesses.
- Nutrition and hydration are inside the defined procedure. The form makes invasive food and water a separate choice.
- Pregnancy is not a customizable checkbox. The statute uses an obstetrician's 20-week and maintainability findings to resolve ambiguity.
- Registered declarations need registry notice too. Physician notice makes revocation effective for care, while the filed copy needs written notice to the Secretary of State.
Common questions
Must I use the form printed in the statute?
No. Section 40:1151.2 calls it illustrative and allows other directions.
May someone else sign my written declaration?
The execution paragraph says the declarant signs in the witnesses' presence. It provides no directed-signer substitute for initial execution.
Does the declaration need notarization?
No notary alternative appears. The statute uses two qualified witnesses.
Will Louisiana recognize a declaration signed elsewhere?
Yes. A declaration properly executed under another state's law is deemed validly executed for Louisiana's Subpart.
Statutes and sources
- La. R.S. § 40:1151.1 — declaration, witness, qualified-patient, condition, life-sustaining-procedure, nutrition, CPR, and comfort definitions. Official text (accessed 2026-07-31).
- La. R.S. § 40:1151.2 — written and nonwritten execution, notice, medical record, illustrative form, treatment choices, and optional registry. Official text (accessed 2026-07-31).
- La. R.S. § 40:1151.3 — revocation methods, effectiveness, record notation, and registered-declaration revocation. Official text (accessed 2026-07-31).
- La. R.S. § 40:1151.6 — certification, transfer, and no registry-search duty. Official text (accessed 2026-07-31).
- La. R.S. § 40:1151.7 — immunity and voluntary-declaration presumption. Official text (accessed 2026-07-31).
- La. R.S. § 40:1151.9 — natural-dying boundary, out-of-state execution, and pregnancy ambiguity rule. Official text (accessed 2026-07-31).
Source links
Every statute quoted above, linked, with the date we checked it.
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