Vermont: Living Will and Advance Health-Care Instruction Requirements
The short answer
Vermont uses a written advance directive that may include the adult's own future treatment instructions. The dated directive requires two adult witnesses, not a notary; remote witnessing is allowed when the witness knows the signer and the statute's live-communication and contact-information conditions are met, and an additional authorized explainer is required when signing during admission to or residence in specified care facilities. The adult may choose immediate effect, a custom condition, or the default clinician-determined incapacity trigger, may state treatment and pregnancy choices, and may later revoke treatment instructions orally, in writing, or by another act showing specific intent.
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This is the general rule in Vermont. Ezel applies current Vermont law to your specific facts and answers with citations to the statutes.
| Governing law and document | 18 V.S.A. ch. 231. A single written 'advance directive' may appoint an agent and include the adult's own health-care desires or treatment goals; it is distinct from a clinician's DNR/COLST order (§§ 9701(1), (6), (8), 9702) |
|---|---|
| Who may make an instruction | Adult with capacity (§§ 9701(4), (23), 9703(a)). Capacity to decide health care means a basic understanding of the condition and the benefits, risks, and alternatives to the proposed care |
| Oral, written, and signature form | Written, dated directive signed by principal, or by another in principal's presence and at express direction if physically unable (§§ 9701(1), 9703(b)). Digital signature permitted. No oral-creation route; no mandatory statutory form (§ 9703(g)) |
| Witness, notary, and disqualifications | 2+ witnesses age 18+; no notary alternative (§ 9703(b)). Physical presence OR remote witness known to principal using live audio-video or telephone, with witness contact/relationship recorded. Agent and principal's spouse, parent, adult sibling, adult child, adult grandchild cannot witness. Facility patient/resident also needs authorized explainer (§ 9703(b)-(e)) |
| Covered conditions and trigger | No universal terminal diagnosis. Directive may take effect on execution, on a maker-selected circumstance even unrelated to capacity, or by default after principal's clinician determines incapacity, records cause/nature/projected duration, and makes reasonable notice efforts (§§ 9702(a)(3)-(4), 9706) |
| Treatment, nutrition, hydration, and comfort | May direct desired or rejected health care, hospitalization/transfer, specific treatment, and any emergency/short- or long-term life-sustaining treatment, including medically administered nutrition/hydration (§ 9702(a)(5), (7), (12)). Natural eating/drinking includes spoon feeding and is outside that defined medical-means category (§ 9701(19)-(20)) |
| Pregnancy and other statutory limits | No default pregnancy override. Adult may direct which life-sustaining treatment is desired or not desired if pregnant when directive becomes effective (§ 9702(a)(8)). Withholding/withdrawal under directive is not suicide; chapter preserves existing law on intentionally hastened death and permits professionally appropriate suffering-relief medication (§ 9715) |
| Revocation, notice, and registry | With or without capacity, may revoke non-agent treatment instructions orally, in writing, or by any act showing specific intent; signed statement, clinician notice entered in record, or burning/tearing/obliterating also revoke all/part (§ 9704). Deliver applicable directive to provider (§ 9705). Registry submission is optional; providers record/flag revocation and notify registry when applicable (§§ 9701(28), 9704(c), 9709(c)(3)) |
| Provider duties, recognition, and effect | Provider must check for effective directive and follow it unless inconsistent with directive/chapter, unlawful/professionally impermissible, or subject to moral/ethical conflict; conflict route requires prompt notice, transfer help, ongoing care, and record documentation (§ 9707). Good-faith statutory compliance is immune (§ 9713); valid out-of-state directive remains enforceable, compliant Vermont directive is presumed valid, and copies count (§§ 9716-9717) |
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Requirements one by one
Put the treatment instructions in a written advance directive
Vermont's § 9701 defines an advance directive as a written record that may
include the adult's own “instructions on health care desires or treatment
goals.” It can share one document with an agent appointment, but the treatment
instructions remain the adult's directions. A DNR or COLST is a separate
clinician order, not something created merely by signing the directive.
Under § 9702(a), the adult may accept or reject health care, hospitalization,
transfer from home, specific treatment, life-sustaining treatment, and other
future health care. The chapter prescribes no single mandatory form.
Date, sign, and use two qualified adult witnesses
Under § 9703, the adult dates and signs the directive. If physically unable
to sign, another individual may sign in the adult's presence and at the adult's
express direction. Two or more witnesses age 18 or older must sign and affirm
that the adult appeared to understand the document and was free from duress or
undue influence. Vermont provides no notary alternative.
A witness may be remote if the adult and witness know each other, communicate
through live interactive audio-video or by telephone, and the directive states
the witness's name, contact information, and relationship to the adult. The
adult, witnesses, and any required explainer may use digital signatures.
The appointed agent and the adult's spouse, parent, adult sibling, adult child,
and adult grandchild cannot witness. A hospital patient, or a person being
admitted to or living in a nursing home or residential care facility, also
needs an authorized person to explain the directive and sign an affirmation.
Choose the event that makes the instruction effective
Vermont does not impose one terminal-condition trigger. Under § 9702(a) and
§ 9706, the directive may take effect immediately, when a stated circumstance
or condition occurs even if unrelated to capacity, or under the default route
when the adult's clinician determines incapacity. For the incapacity route, the
clinician records the cause, nature, and projected duration and makes reasonable
efforts to notify the adult and any agent or guardian.
State treatment, nutrition, hydration, and pregnancy choices separately
The directive may address any desired or rejected health care and any emergency,
short-term, or long-term life-sustaining treatment. Section 9701 defines
life-sustaining treatment to include antibiotics and nutrition or hydration
administered by medical means. Natural eating and drinking—including spoon
feeding or similar help—are outside that defined medical-means category.
Section 9702(a)(8) expressly lets the adult say which life-sustaining
treatment is desired or not desired if pregnant when the directive takes
effect. The chapter supplies no default pregnancy override. Section 9715
also says withholding or withdrawing life-sustaining treatment under a limiting
directive is not suicide and preserves professionally appropriate medication
used to relieve suffering even if it may unintentionally hasten death.
Revoke an instruction and communicate the change
Under § 9704, an adult with or without capacity may revoke a treatment
instruction orally, in writing, or by any other act showing a specific intent
to revoke. A signed statement, personal notice to the clinician for entry in
the medical record, or burning, tearing, or obliterating the directive can
revoke all or part of it. The special over-objection provision has a separate
capacity limit, but ordinary treatment instructions do not.
Section 9705 requires a person holding an applicable directive to deliver it
to the clinician or care facility unless a copy is already available. Registry
filing is optional: § 9701 says individuals “may submit” a directive or its
location, and § 9709 tells facilities to encourage and help filing. Providers
record and flag a known revocation and notify the registry when applicable.
Providers generally must follow or arrange continued care and transfer
Under § 9707, a provider treating a patient without capacity first attempts
to determine whether an advance directive is in effect and generally follows
its instructions. A provider may refuse an instruction that conflicts with the
directive or chapter, would violate criminal law or professional standards, or
creates a moral or ethical conflict. The conflict route requires prompt notice,
help transferring care, ongoing care until a new provider is found, and medical-
record documentation.
Good-faith statutory compliance receives the immunity stated in § 9713.
Section 9716 preserves an out-of-state directive executed in compliance with
the law where it was made, while § 9717 presumes a compliant Vermont
directive valid and gives a photocopy or facsimile the same reliance as the
original.
What trips people up
- A notary does not replace the two witnesses. A notary-only execution path
is not in § 9703. - Remote does not mean anonymous. The remote witness must already be known
to the adult, communicate live, and be identified in the directive with
contact and relationship information. - Signing in a care facility may require a third participant. The authorized
explainer's signed affirmation is additional to the two witnesses. - The trigger is a drafting choice. A form that silently assumes only
terminal illness or only incapacity can be narrower than Vermont law.
Common questions
Does the directive itself create a DNR or COLST order?
No. Chapter 231 treats DNR and COLST orders as clinician orders. The advance
directive may state treatment wishes that inform later decisions, but it is not
itself the clinician order.
Must I file the directive in the State registry?
No. Filing is optional, although facilities must encourage and help a patient
submit the directive or information about where it is located.
May a provider rely on a copy instead of the original?
Yes. Section 9717 says a photocopy or facsimile of a duly executed directive is
relied on to the same extent as the original.
Statutes and sources
- 18 V.S.A. §§ 9701-9707, 9709, and 9713-9717 — document and definitions,
adult capacity, treatment and pregnancy choices, execution, witnesses,
facility explainer, revocation, delivery, activation, provider duties,
registry, immunity, interpretation, reciprocity, and validity. Official
current Chapter 231
(accessed July 31, 2026).
Source links
Every statute quoted above, linked, with the date we checked it.
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