Living Will and Advance Health-Care Instruction Requirements in Vermont

At a glance

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).