Living Will and Advance Health-Care Instruction Requirements in Maine

At a glance

Maine uses the Uniform Health Care Decisions Act, 18-C M.R.S. §§ 5-801–5-817. Under § 5-802(1), an advance health care directive can be an adult's own individual instruction, a health-care power of attorney, or a combined form. This page covers the adult's instruction, not the agent appointment or a clinician order.

Requirements one by one

An individual instruction may be oral or written

Under § 5-803(1), an adult with capacity may give an instruction orally or in writing and may make it effective only when a stated condition arises. An oral instruction is valid only if made to a health care provider or to someone eligible to serve as a surrogate under § 5-806(2).

That instruction-only subsection does not require a signature, date, witnesses, or notarization. Maine's optional combined form is different: § 5-805 tells the user to sign and date at the end and to have two individuals sign as witnesses. If the document also appoints an agent, § 5-803(2) separately requires the principal and two witnesses to sign in person rather than electronically.

Remote directed signing is a narrow facility exception

Maine's isolation rule, § 5-803-A, applies when an infectious disease confines a principal to an isolation area in a hospital or residential health care facility and the needed people or documents cannot be physically present. Another person in the same facility may sign the principal's name at the principal's direction, and real-time two-way audiovisual communication may be used for the direction and witnessing. The principal first receives an unsigned copy to review; the signed and witnessed original is filed in the medical record. The section does not apply in other settings or to notarized documents.

The maker may set the activating condition

The instruction may name its own activating condition. Unless a written directive specifies another method, § 5-803(4) assigns determinations of incapacity, recovery, or another condition affecting the instruction to the primary physician or a court. A qualified examiner may make the determination for a directive authorizing mental-health treatment.

The optional form's no-prolongation choice applies in three alternatives: an incurable and irreversible condition expected to cause death relatively soon; unconsciousness with no expected recovery to a reasonable degree of medical certainty; or treatment whose likely risks and burdens outweigh its expected benefits (§ 5-805).

Feeding and pain relief are separate form provisions

The optional form lets the adult choose either not to prolong life in those circumstances or to prolong life as long as possible within generally accepted health care standards. Artificial nutrition and hydration follows that choice unless the adult marks the separate box requiring it regardless of condition and the end-of-life choice.

Unless the adult writes a different instruction, the form directs that pain or discomfort treatment be provided at all times, even if it hastens death (§ 5-805). The Act's definition of a health care decision also includes directions to provide, withhold, or withdraw artificial nutrition and hydration and other health care, including life-sustaining treatment (§ 5-802(6)).

What trips people up

• The instruction and agent-appointment formalities are not interchangeable. The oral-or-written instruction rule is in § 5-803(1). The in-person principal-and-two-witness rule in § 5-803(2) governs a health-care power of attorney, while the optional combined form supplies its own signing block.
• The Act has no pregnancy-specific override. The official Part 8 contents and § 5-805 form contain no pregnancy suspension, viability test, or live-birth rule. Section 5-814 instead states the Act's assisted-suicide, euthanasia, other-law, and accepted-standards limits.
• A provider may decline through a defined process. Under § 5-808, a provider or institution may rely on Part compliance, conscience, medically ineffective care, or generally accepted standards. It must give prompt notice, continue care pending transfer or a final court order, and make reasonable transfer efforts unless assistance is refused.

Common questions

Does every treatment instruction need two witnesses? No. The instruction-only route in § 5-803(1) states no witness requirement. The optional combined form directs two witness signatures, and a document that appoints an agent is subject to the separate health-care-POA rule.

How may I revoke the treatment instructions? While you have capacity, you may revoke any non-agent part at any time and in any manner communicating an intent to revoke (§ 5-804(2)). A provider, agent, guardian, or surrogate who learns of the revocation must promptly notify the supervising provider and treating institution (§ 5-804).

Will Maine recognize an instruction made elsewhere? Yes, if it complies with Maine's Part 8 or is valid under the law of the state where it was executed. A directive valid where executed or communicated is valid for Maine Part 8 purposes (§ 5-803(8)).

Does Maine operate a directive registry under this Act? No registry provision appears among the official Part 8 sections. Under § 5-808(2), providers instead record a known directive or revocation and maintain a furnished written copy in the patient's health care record. Good-faith provider and institution actions described in § 5-810(1) receive the stated immunity, and § 5-813 gives a copy of a written directive or revocation the same effect as the original.

Statutes and sources

• 18-C M.R.S. § 5-802 — definitions of advance directive, capacity, instruction, covered health-care decisions, life-sustaining treatment, persistent vegetative state, and terminal condition. Maine Legislature (accessed 2026-07-31).
• 18-C M.R.S. §§ 5-803 and 5-803-A — oral or written instructions, conditional operation, health-care-POA distinction, default determination, interstate validity, and the facility-isolation signing process. Maine Legislature (accessed 2026-07-31).
• 18-C M.R.S. §§ 5-804 and 5-805 — revocation and the optional combined form's treatment, feeding, and pain-relief provisions. Maine Legislature (accessed 2026-07-31).
• 18-C M.R.S. §§ 5-808 and 5-810 — provider records, compliance, refusal, transfer, and good-faith immunity. Maine Legislature (accessed 2026-07-31).
• 18-C M.R.S. §§ 5-812–5-813 — capacity presumption and copy effect. Maine Legislature (accessed 2026-07-31).
• 18-C M.R.S. § 5-814(2)–(4) — insurance and homicide effect, prohibited practices, and generally accepted health-care standards. Maine Legislature (accessed 2026-07-31).