Living Will and Advance Health-Care Instruction Requirements in West Virginia

At a glance

West Virginia's Health Care Decisions Act, §§ 16-30-1–16-30-25, creates a standalone living will and a combined medical-power-of-attorney and living-will form. The living will is the adult's own instruction about life-prolonging intervention; it is distinct from an agent's appointment.

Requirements one by one

Execution requires witnesses and a notary

Under § 16-30-4(a), a competent adult signs a written, dated living will. If physically unable, another person may sign in the principal's presence at the principal's express direction. The signature occurs before at least two adult witnesses. Those witnesses sign and attest, and their signatures and attestations must be acknowledged before a notary public.

A witness cannot be the directed signer, a blood or marriage relative, a known will beneficiary, a person directly responsible for medical bills, the attending physician, the medical-power-of-attorney representative, or the successor (§ 16-30-4(b)). An unaware beneficiary does not invalidate the document solely because the witness did not know of that status.

For Article 30, § 16-30-3 defines adult to include a person age 18 or older, an emancipated minor, or a mature minor whose decision capacity an authorized clinician has determined.

The living will uses a terminal-condition trigger

The statutory form applies when the person is very sick, cannot communicate, and one physician who personally examined the person certifies a terminal condition. A terminal condition is incurable or irreversible and one for which life-prolonging intervention would only prolong dying (§§ 16-30-3 and 16-30-4(g)).

After notice of the living will and diagnosis, § 16-30-19 requires the attending physician to arrange confirmation, written certification, and medical-record documentation of terminal condition. Incapacity is separately determined after personal examination and recorded contemporaneously with its basis, cause, nature, and expected duration if known (§ 16-30-7).

West Virginia's living-will definition and statutory form do not use persistent vegetative state as an alternative trigger.

The form names treatment and feeding consequences

The form directs withholding or withdrawal of life-prolonging intervention. It specifically explains that this means removal or refusal of CPR, a ventilator, dialysis, and medically administered food and fluids through an IV or feeding tube (§ 16-30-4(g)).

Medication and procedures needed for comfort or pain relief are excluded from "life-prolonging intervention" under § 16-30-3. The form asks for as much medication as necessary to alleviate pain and says oral food and fluids should be offered as desired and tolerated.

The person's instruction wins a conflict

Under § 16-30-5, the person's expressed directive prevails over a POST form or an agent's or surrogate's decision. If two advance directives conflict, the more recent one controls only as far as needed to resolve the inconsistency.

A capable adult continues to make personal health-care decisions under § 16-30-6(a). If a provider refuses an already-effective directive because the principal now asks for different care, § 16-30-22(c) requires the specified two-professional certification of regained capacity before treating the directive as inapplicable.

Revocation depends on communication and a record

Under § 16-30-18, the principal may revoke by directed destruction, by a signed and dated writing delivered to the attending physician, or by an oral statement before an adult witness who signs and dates a confirmation. The oral route becomes effective when communicated to the attending physician. The physician records the notice's required details in the medical record.

Article 30 states no registry filing or registration step for validity. Instead, § 16-30-4(d) makes the principal or representative responsible for notifying providers and requires a presented directive, copy, or revocation to be placed in the medical record.

Providers must comply or use the transfer rules

Good-faith action under reasonable medical standards receives civil and criminal immunity under § 16-30-10. An attending physician who cannot comply must effect transfer to a physician who will honor the living will.

§ 16-30-12 separately preserves a facility's published religious or moral policy and an individual provider's sincerely held objection. The provider must promptly disclose the refusal and cooperate with transfer. A provider or facility with actual knowledge can face licensing review for noncompliance under § 16-30-22.

What trips people up

• Notarization is additional, not alternative. Two witnesses sign and attest, and their signatures and attestations are then acknowledged before a notary (§ 16-30-4(a)).
• The statutory living will is terminal-condition only. It does not add a persistent-vegetative-state option. Broader nonterminal decision authority belongs to the separate medical-power-of-attorney track.
• Tube or IV nutrition is part of life-prolonging intervention. The form's withdrawal direction includes medically administered food and fluids but preserves tolerated oral food and fluids and comfort measures.
• The Act has no pregnancy override. Article 30 and its statutory form state no pregnancy, viability, or live-birth rule for the adult's living will.

Common questions

May a person use a different form? Yes. § 16-30-4(g) says the statutory form is optional and permits other specific directions that do not conflict with the Act.

What if two directives conflict? The most recently completed directive controls only to the extent necessary to resolve the conflict under § 16-30-5(c).

Will West Virginia recognize a living will signed elsewhere? Yes. § 16-30-21 recognizes one executed under West Virginia law or the law of the state where it was signed.

Does withholding treatment count as assisted suicide? No. § 16-30-15 says the Act does not legalize mercy killing or assisted suicide and distinguishes lawful withholding or withdrawal under the Act.

Statutes and sources

• W. Va. Code §§ 16-30-3 and 16-30-4 — definitions, execution, witness/notary rules, optional forms, terminal trigger, treatment choices, notice, and medical-record placement. West Virginia Legislature (accessed 2026-07-31).
• W. Va. Code §§ 16-30-5 through 16-30-7 — conflicts, current capable-adult control, validity presumption, and incapacity findings. Same official source (accessed 2026-07-31).
• W. Va. Code §§ 16-30-10 and 16-30-12 — immunity, noncompliance transfer, and conscience objections. Same official source (accessed 2026-07-31).
• W. Va. Code § 16-30-15 — assisted-suicide and mercy-killing boundary. Same official source (accessed 2026-07-31).
• W. Va. Code §§ 16-30-18 and 16-30-19 — revocation and terminal-condition confirmation/documentation. Same official source (accessed 2026-07-31).
• W. Va. Code §§ 16-30-21 and 16-30-22 — reciprocity, actual-knowledge consequences, and regained-capacity certification. Same official source (accessed 2026-07-31).