Living Will and Advance Health-Care Instruction Requirements in New Hampshire

At a glance

New Hampshire's RSA chapter 137-J combines a durable power of attorney for health care and a living will in one advance-directive form. A person may complete either or both components. The living will gives written treatment guidance; it is not itself a DNR or POLST medical order.

Requirements one by one

The statutory disclosure and form are part of execution

Under § 137-J:13, anyone executing an advance directive must first receive the substantially prescribed disclosure, and the directive must substantially follow § 137-J:20. The principal is age 18 or older and must have capacity to understand and appreciate the decision's nature, consequences, significant benefits and harms, and reasonable alternatives (§ 137-J:2(VI), (XXIII)).

The principal signs in the physical presence of two subscribing witnesses, a notary, or a justice of the peace (§ 137-J:14). If physically unable, a directed signer may write the principal's name in the principal's physical presence.

The witness route has a detailed screen. Neither witness may be the agent, surrogate, spouse, heir, named property taker, attending practitioner, or a person under that practitioner's direction or control. No more than one may be the principal's health or residential provider or its employee.

Two independent practitioners certify the trigger

The living-will definition in § 137-J:2(XVII) requires medical-record certification by two attending physicians, or by a physician and another attending practitioner not under the certifying physician's supervision. They certify both loss of capacity and either permanent unconsciousness or an advanced life-limiting, incurable, progressive condition for which treatment has become excessively burdensome or ineffective.

The form's burden examples include active dying, permanent unconsciousness without reasonable hope of recovery, and an advanced condition for which likely risks and burdens outweigh expected benefits (§ 137-J:20).

The form uses a burdens-and-benefits choice

The principal chooses between all attempts at life-sustaining treatment within accepted standards and a limit to treatment that is not excessively burdensome and has reasonable hope of benefit. The principal may cross out listed burden examples and add personal situations.

Life-sustaining treatment includes medically administered nutrition and hydration, mechanical respiration, dialysis, external devices, blood-pressure drugs, transfusions, and antibiotics. It excludes comfort and pain procedures and natural eating or drinking (§ 137-J:2(XVI), (XVIII)). The living-will form explains that stopping medically administered nutrition and hydration may be part of comfort-focused care when the treatment is excessively burdensome.

Pregnancy has a specific two-clinician exception

Under § 137-J:10(II)(a), life-sustaining treatment may not be withheld from a pregnant principal unless the attending practitioner and an obstetrician who examined the principal certify that treatment will not permit continuing fetal development and live birth, will physically harm the principal, or will prolong severe pain that medication cannot alleviate.

The chapter also states that withholding or withdrawal under the Act is not suicide or murder and does not authorize suicide, assisted suicide, mercy killing, euthanasia, or a deliberate life-ending act beyond natural dying (§ 137-J:10(I)).

Revocation needs one of the statutory routes

Under § 137-J:15, the principal may revoke through a signed and dated writing delivered to the agent, surrogate, or provider; an oral statement before two people qualified to witness execution; directed destruction or another act showing specific intent; or a later advance directive. Revocation becomes effective when communicated to the attending practitioner, and the provider records and circulates notice to the care team.

The divorce, separation, annulment, and protective-order filing rule addresses the primary agent designation and any alternate. It does not erase the living will's treatment guidance. Chapter 137-J states no registry filing requirement.

Providers follow the directive or arrange transfer

§ 137-J:7 requires providers to follow applicable directions within responsible medical practice, place a copy in the record on request, and promptly verify incapacity when the directive may apply. A conscience objector must arrange transfer without delay and may not withhold interim treatment whose denial would hasten death against the principal's expressed wishes.

Good-faith action within reasonable medical standards receives the immunity in § 137-J:12. A living will valid in another state is effective in New Hampshire subject to chapter 137-J's limits (§ 137-J:17).

What trips people up

• Witnesses must see the signature. The witness route requires signing in their physical presence; acknowledgment belongs to the notary or justice of the peace route.
• The trigger is not simply “near death.” It requires loss of capacity and the statute's permanent-unconsciousness or advanced-condition findings, certified by two independent practitioners.
• Natural eating and drinking are not life-sustaining treatment. The form can address tube or IV nutrition and hydration, but the statute separates those from eating and drinking.
• The agent can override a conflicting living will. If the durable-power component conflicts with the living-will component, § 137-J:21(II) says the durable power of attorney for health care controls.

Common questions

Can I use a notary instead of witnesses? Yes. A notary or justice of the peace is an alternative to two subscribing witnesses under § 137-J:14.

May one witness work for my care provider? Yes, but no more than one witness may be the provider or its employee.

Will New Hampshire honor a living will signed elsewhere? Yes, if it was valid where executed, subject to New Hampshire's substantive limits (§ 137-J:17).

Is the advance directive itself a DNR order? No. The mandatory disclosure in § 137-J:19 says it is not, by itself, a DNR or POLST medical order.

Statutes and sources

• RSA 137-J:2 — capacity, living-will trigger, life-sustaining treatment, nutrition/hydration, and age definitions. New Hampshire General Court (accessed 2026-08-13).
• RSA 137-J:7, :10, and :12 — provider duties and transfer, pregnancy and criminal-act limits, and immunity. Same official source (accessed 2026-08-13).
• RSA 137-J:13 through :15 — required disclosure/form, execution routes, witnesses, directed signing, and revocation. Same official source (accessed 2026-08-13).
• RSA 137-J:17 — out-of-state recognition. Same official source (accessed 2026-08-13).
• RSA 137-J:19 and :20 — disclosure and living-will form choices. Same official source (accessed 2026-08-13).
• RSA 137-J:21 — health-care POA controls a conflicting living will. Same official source (accessed 2026-08-13).