Advance Directives
Advance directives let you document your medical wishes before you’re unable to speak for yourself. Governed by 20 Pa. Cons. Stat. Ann. §§ 5421–5447.
Types of Advance Directives
Living Will
Directs end-of-life care preferences (life-sustaining treatment, artificial nutrition/hydration). Takes effect when two physicians certify terminal condition or permanent unconsciousness.
POLST (Physician Orders for Life-Sustaining Treatment)
Medical order signed by physician. More immediately actionable than living will. Used for seriously ill patients. Translates patient wishes into physician orders.
Decisions to Address in a Living Will
Mechanical ventilation
Whether to be placed on or continue use of a ventilator/breathing machine
Artificial nutrition/hydration
Whether to receive food and water through a tube
Cardiopulmonary resuscitation (CPR)
Whether emergency measures should be taken to restart your heart
Dialysis
Whether to continue or begin kidney dialysis
Antibiotics
Whether to administer antibiotics for infections
Comfort care only
Pain management and comfort measures without curative treatment
Living Will vs. POLST
| Feature | Living Will | POLST |
|---|---|---|
| Who creates it | Any competent adult | Seriously ill patients with physician |
| Legal form | Advance directive (patient’s wishes) | Medical order (physician’s order) |
| When it takes effect | Terminal condition or permanent unconsciousness certified by 2 physicians | Immediately upon signing |
| Who signs | Patient + 2 witnesses | Patient + physician |
| Portability | Must be presented to providers | Bright yellow form—recognized by EMS/hospital staff on sight |
| Scope | End-of-life preferences | Specific medical orders (CPR, intubation, antibiotics, feeding) |
Execution Requirements
Important Considerations
Keep copies accessible: Provide copies to your physician, healthcare agent, hospital, and a trusted family member. An advance directive that can’t be found when needed is effectively useless.
Review periodically: Update your directives when your health status changes, after a major diagnosis, or every 3–5 years to ensure they still reflect your wishes.
Pregnancy provision: Under PA law, a living will is not effective during pregnancy if it would result in the death of the fetus, unless the fetus is not viable.
Legal Disclaimer
Notice: Estate administration and planning involve complex legal, tax, and fiduciary considerations. This information is provided for educational purposes. Consult with a licensed attorney and tax professional for guidance specific to your situation.
Content prepared under the supervision of a PA licensed attorney. Last updated April 2026.