Living Will and Advance Health-Care Instruction Requirements in Montana

At a glance

Montana uses a standalone declaration under the Rights of the Terminally Ill Act, Mont. Code Ann. title 50, chapter 9. The declaration addresses withholding or withdrawal of life-sustaining treatment in a terminal condition. It is separate from a general durable health-care power of attorney and from an emergency-services living-will protocol.

Requirements one by one

The declaration needs a signature and two witnesses

Under § 50-9-103(1), the declarant must be at least 18 and of sound mind. The declarant signs personally or directs another person to sign, and two individuals must witness the declaration. The Act does not make notarization an alternative and does not list witness-age, relationship, inheritance, provider, facility, or designee disqualifications.

The two printed forms in § 50-9-103 are optional. They include a date, signature, residence, and two witness blocks, but the subsection's operative execution sentence does not separately require a date. Chapter 9 states no oral creation route or electronic-specific execution method.

One attending clinician makes both activating findings

The declaration becomes operative only when it has been communicated to the attending physician or attending advanced practice registered nurse and that clinician determines both that the declarant has a terminal condition and can no longer decide about life-sustaining treatment (§ 50-9-105).

A terminal condition is incurable or irreversible and, without life-sustaining treatment, is expected by the attending clinician to cause death relatively soon. Covered treatment is a procedure or intervention that would serve only to prolong the dying process (§ 50-9-102). The Act does not add a permanent- unconsciousness or persistent-vegetative-state route.

Comfort treatment, including feeding, remains

The optional direct-instruction form tells the clinician to withhold or withdraw treatment that only prolongs dying and is not necessary for comfort or pain relief. Section 50-9-202(2) preserves the provider's responsibility to give treatment, including nutrition and hydration, for comfort care or alleviation of pain.

The Act does not print a separate artificial-nutrition-or-hydration election. Its treatment direction and the comfort-care rule must be read together rather than turning feeding into an automatic all-or-nothing choice.

What trips people up

• Pregnancy uses a probable-live-birth test. Life-sustaining treatment may not be withheld or withdrawn under the declaration while the attending clinician knows the patient is pregnant and continued treatment probably would allow the fetus to develop to live birth (§ 50-9-202(3)).
• Organ-preservation measures need an express contrary instruction. If the prospective donor is in a health care facility, measures needed to preserve organ suitability may not be withheld or withdrawn unless the declaration expressly says otherwise (§ 72-17-216).
• Registry filing is optional. § 50-9-501, § 50-9-502, and § 50-9-503 establish the Attorney General's registry, but failure to file does not affect declaration validity and failure to notify the registry does not invalidate a revocation. Providers are not required to search it.

Common questions

May a notary replace the two witnesses? No. § 50-9-103(1) requires the declaration to be witnessed by two individuals and states no notarial alternative.

Can I revoke after losing capacity? The statute says a declarant may revoke at any time and in any manner, without regard to mental or physical condition. Effectiveness depends on communication under § 50-9-104, and the provider records the revocation.

What if the provider or facility will not comply? The provider must take all reasonable steps as promptly as practicable to transfer care to a willing provider. A facility whose policy prevents compliance must take all reasonable steps to transfer the patient to a facility that can carry out the Act (§ 50-9-203). § 50-9-204 supplies the chapter's stated immunity for qualifying conduct, while § 50-9-205 preserves reasonable medical standards and does not authorize mercy killing or euthanasia.

Will Montana recognize a declaration made elsewhere? An out-of-state declaration is effective for chapter 9 if it was made in a manner substantially similar to § 50-9-103 and complies with the law of the state where it was executed (§ 50-9-111).

Statutes and sources

• Mont. Code Ann. §§ 50-9-102–105 — definitions, execution, optional forms, revocation, notice, and operative trigger. Montana Legislature, MCA 2025 (accessed 2026-07-31).
• Mont. Code Ann. § 50-9-111 — out-of-state declarations. Same official source (accessed 2026-07-31).
• Mont. Code Ann. §§ 50-9-201–205 — recordkeeping, current patient choice, comfort care, pregnancy, transfer, immunity, insurance, and statutory limits. Same official source (accessed 2026-07-31).
• Mont. Code Ann. §§ 50-9-501–503 — optional declaration registry, filing, access, and removal. Same official source (accessed 2026-07-31).
• Mont. Code Ann. § 72-17-216 — organ-suitability measures and express contrary directions. Same official source (accessed 2026-07-31).