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Pennsylvania Living Will Form

Pennsylvania living will is a legal document that states the health care treatments a patient (the “principal”) wishes to receive upon losing their ability to communicate. The terms of the form are related to end-of-life care, life-sustaining procedures, and organ donation. The principal will outline their health care decisions in Part 2 of the document linked on this page. If the principal would also like to designate a medical decision maker, or “health care agent,” they may do so by completing the Medical Power of Attorney form found in Part 1 of this document. Completing both parts of the form creates an Advance Directive for the principal.

Laws Title 20, Chapter 54, Subchapter B (Living Wills)

Signing Requirements (§ 5442) – Two (2) Witnesses

Statutory Form § 5471

State Definition

“Living will.”  A writing made in accordance with this chapter that expresses a principal’s wishes and instructions for health care and health care directions when the principal is determined to be incompetent and has an end-stage medical condition or is permanently unconscious.