Minnesota: Living Will and Advance Health-Care Instruction Requirements
The short answer
Minnesota uses a broad written health care directive that may contain treatment instructions without naming an agent. An adult with capacity signs and dates it, states a name, and uses either a notary or two adult witnesses; at least one witness must be independent of the direct-care provider. The instructions ordinarily operate when a physician, advanced practice registered nurse, or physician assistant finds that the adult lacks decision-making capacity, and a pregnancy presumption favoring life-sustaining care can be displaced by pregnancy-specific instructions or clear and convincing evidence of contrary wishes.
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This is the general rule in Minnesota. Ezel applies current Minnesota law to your specific facts and answers with citations to the statutes.
| Governing law and document | Minn. Stat. ch. 145C, Health Care Directives Act: one written 'health care directive' may contain health care instructions, a health care power of attorney, or both (§§ 145C.01, 145C.03). § 145C.16 is a nonmandatory suggested form. § 145C.18 separately creates a narrow written nonopioid directive. |
|---|---|
| Who may make an instruction | A 'principal': individual age 18+ with capacity to execute (§§ 145C.01 subd. 8, 145C.02–.03). Decision-making capacity means understanding significant benefits, risks, and alternatives and making/communicating a decision (§ 145C.01 subd. 1b). Another person authorized by the adult may sign (§ 145C.03 subd. 1(4)). |
| Oral, written, and signature form | General directive: writing, date, adult's name, and adult's or authorized signer's signature, verified by notary OR witnesses (§ 145C.03). The suggested form permits signature acknowledgment before each verifier. Chapter 145C states no general electronic-execution route. Separate § 145C.18 nonopioid directive is a written instrument executed by a patient with capacity; no witness/notary formality is stated there. |
| Witness, notary, and disqualifications | Notary OR 2 witnesses, not both (§§ 145C.03, 145C.16). Suggested form makes each witness age 18+. If an agent is appointed, that agent/alternate cannot witness or notarize. At least 1 witness must not be a direct-care provider or that provider's employee; the other may be. A direct-care provider employee may notarize. No inheritance or relationship bar. |
| Covered conditions and trigger | No terminal-condition diagnosis is required. By default the directive is effective for a decision when the attending physician, APRN, or physician assistant determines the adult lacks capacity for that decision; effectiveness ends on recovery (§ 145C.06). The adult may state other conditions, and the directive may contain values, preferences, guidelines, or directions about any covered health care (§§ 145C.01, 145C.05). |
| Treatment, nutrition, hydration, and comfort | May address any physical or mental health care, including consent/refusal/withdrawal and tube/parenteral nutrition or hydration (§ 145C.01). Suggested form covers recovery, dying, permanent unconsciousness, complete dependency, named treatments, and pain relief (§ 145C.16). A separate nonopioid directive bars opioid administration/offers, subject to emergency-record-access and substance-use-disorder-treatment exceptions (§ 145C.18, current through 2026 ch. 127). |
| Pregnancy and other statutory limits | If the adult lacks capacity and there is a real possibility life-sustaining care could allow fetal survival to live birth, provider presumes the adult wanted care sustaining both lives (§ 145C.10(g)). Pregnancy-specific directive terms negate that presumption; absent terms, clear and convincing evidence of contrary competent wishes also negates it. Chapter 145C excludes assisted suicide and does not authorize mercy killing/euthanasia (§§ 145C.01, 145C.14). |
| Revocation, notice, and registry | With capacity, revoke all/part anytime by directed destruction, signed dated writing, verbal statement before 2 witnesses (not necessarily together), or later inconsistent directive (§ 145C.09). A patient who personally made a nonopioid directive may revoke anytime in any communicable manner (§ 145C.18). Chapter 145C creates no directive registry; copies equal originals, and the suggested form recommends giving copies for medical records (§§ 145C.10(f), 145C.16). |
| Provider duties, recognition, and effect | Instructions may direct providers and must be followed so long as they address the adult's needs (§§ 145C.02, 145C.16); good-faith, standard-of-care action is protected (§ 145C.11). Directed life-sustaining care must be provided or arranged unless the directive says otherwise (§ 145C.15). Providers must follow a nonopioid directive subject to statutory exceptions (§ 145C.18). A directive valid where executed or under Minnesota formalities is recognized (§ 145C.04). |
Compare this rule across all 50 states + DC →
Minnesota uses one broad health care directive rather than a narrow terminal-
condition living will. The adult may write treatment instructions, appoint an
agent, or do both. This page addresses the adult's own instructions; the agent's
general powers are separate.
Requirements one by one
The directive is written, dated, signed, and verified one of two ways
Under § 145C.03, the directive must be in writing, dated, state the adult's
name, and be signed by the adult or an authorized signer. The signature is then
verified either by a notary or by witnesses. Minnesota's § 145C.16 suggested
form uses two witnesses and expressly says the form itself is not mandatory.
Each witness must be at least 18 under the suggested form. If the document also
appoints an agent, the named agent or alternate cannot witness or notarize it.
At least one witness must be independent of the provider giving direct care; the
other witness may be that provider or an employee. The statute imposes no
inheritance or relationship disqualification.
Minnesota does not require a terminal diagnosis
A health care instruction may state the adult's values, preferences, guidelines,
or directions about any covered health care. By default, § 145C.06 makes it
effective for a decision when the attending physician, advanced practice
registered nurse, or physician assistant determines that the adult lacks
decision-making capacity for that decision. It stops operating when capacity
returns. The adult may specify different conditions.
The suggested form illustrates the breadth: reasonable chance of recovery,
dying, permanent unconsciousness, complete dependency, and named treatments.
Those examples are choices, not statutory diagnoses that every Minnesota
directive must use.
Nutrition, hydration, mental care, and pain instructions are covered
Section 145C.01 defines health care broadly enough to include physical and
mental treatment and nutrition or hydration supplied parenterally or through
intubation. Part II of the suggested form names ventilation, tube food and
fluids, resuscitation, surgery, dialysis, antibiotics, and transfusions, and it
invites the adult to address pain relief and comfort.
Minnesota also has a separate narrow nonopioid directive in § 145C.18.
A patient with capacity may execute a written instruction barring opioid
administration or an offered prescription and may later revoke in any manner
that communicates intent. Providers generally must comply.
Effective July 1, 2026, 2026 Minnesota Laws chapter 127 added an exception for
an opioid prescribed or administered to treat substance use disorder and added
matching good-faith immunity. That enacted text controls over the older compiled
subdivision displayed on the 2025 statute page (§ 645.02).
Pregnancy creates a rebuttable life-sustaining-care presumption
Under § 145C.10(g), if the adult lacks capacity and reasonable medical
judgment finds a real possibility that care sustaining the adult and fetus could
allow the fetus to survive to live birth, the provider presumes the adult wanted
that care even if withdrawal would otherwise be authorized.
The presumption does not override the adult's expressed choice. Pregnancy-
specific health care instructions under § 145C.05 negate it. Without such a
clause, clear and convincing evidence that the adult's competent wishes were to
the contrary also negates it.
Chapter 145C excludes treatment violating Minnesota's assisted-suicide statute
and does not authorize mercy killing or euthanasia (§ 145C.14).
The two directives use different revocation rules
A general directive may be revoked, while the adult has capacity, by destroying
it or directing destruction in the adult's presence, a signed dated written
statement, a verbal statement before two witnesses who need not be together, or
a later inconsistent directive (§ 145C.09).
The patient who personally made a nonopioid directive has a broader rule: revoke
at any time and in any manner that communicates the intent. Chapter 145C creates
no central registry. Section 145C.10(f) gives a copy the same effect as the
original, and the suggested form recommends distributing signed copies for the
medical record.
Providers follow applicable instructions within good-faith standards
Under § 145C.02, instructions may direct providers and other decision
makers, and the suggested form says the instructions must be followed so long as
they address the adult's needs. Under § 145C.11, a provider acting in good
faith and under applicable care standards is protected.
Under § 145C.15, providers must take reasonable steps to provide directed
life-sustaining health care, nutrition, or hydration when it has a significant possibility of
sustaining life and is legally and actually available, including transfer when
needed—but that duty does not apply when the directive states a contrary intent.
An out-of-state directive is sufficient if valid where executed or under
Minnesota's formalities (§ 145C.04).
What trips people up
- Minnesota is broader than a classic living will. Terminal illness and
permanent unconsciousness are optional scenarios, not mandatory triggers. - Only one witness must be independent of direct care. A provider or employee
may be the other witness, and a direct-care employee may notarize. - Pregnancy is a presumption, not a categorical suspension. Express directive
terms or clear and convincing evidence of contrary wishes can overcome it. - The nonopioid directive has its own execution and revocation rules. Do not
import the general directive's two-witness verbal-revocation method into it.
Common questions
May I write instructions without naming an agent?
Yes. Sections 145C.01 and 145C.03 allow instructions, an agent appointment, or
both.
Do I need both witnesses and a notary?
No. Minnesota makes them alternatives; the witness route uses two adult
witnesses (§§ 145C.03, 145C.16).
Must I be terminally ill before the instructions can operate?
No. By default the trigger is loss of capacity for the decision, unless you
write other conditions (§ 145C.06).
Will Minnesota recognize a directive signed elsewhere?
Yes, if it complied with the execution state's law or Minnesota's § 145C.03
formalities (§ 145C.04).
Statutes and sources
- Minn. Stat. §§ 145C.01 through 145C.06 — definitions, instruction scope,
writing, date, signature, notary/witness choice, pregnancy terms, and timing.
Official Chapter 145C pages
(accessed 2026-07-31). - Minn. Stat. §§ 145C.09 through 145C.16 — revocation, presumptions,
pregnancy, immunity, life-sustaining care, limits, recognition, and suggested
form. Official Chapter 145C pages
(accessed 2026-07-31). - Minn. Stat. § 145C.18 — separate nonopioid directive, execution,
revocation, compliance, exceptions, and immunity. Official compiled text
and 2026 amendment
(accessed 2026-07-31). - Minn. Stat. § 645.02 — July 1 default for an enacted act containing
appropriations. Official text
(accessed 2026-07-31).
Source links
Every statute quoted above, linked, with the date we checked it.
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