Health Care Directive North Dakota: Living Will and Medical POA Combined

Your parent is heading into surgery, and you realize nobody has the legal authority to make medical decisions if something goes wrong. In North Dakota, you don't need two separate documents for this — the state combines the medical power of attorney and the living will into a single Health Care Directive under NDCC Chapter 23-06.5.

But the execution rules are strict, and getting them wrong can leave your family locked out of medical decisions at the worst possible moment.

What the Health Care Directive Covers

North Dakota's Health Care Directive does two things in one document. First, it appoints a health care agent — someone authorized to make medical decisions when the principal can't communicate. Second, it contains living will provisions that direct end-of-life care preferences, including decisions about life-sustaining treatment, artificial nutrition, and hydration.

The state does not provide a separate "medical power of attorney" form. If someone tells you to get a medical POA in North Dakota, they're talking about the Health Care Directive.

Signature Verification: Notary or Two Witnesses

The principal's signature must be verified by either a notary public or at least two witnesses who are at least 18 years old. You don't need both — one method is sufficient.

However, the witness disqualification rules are unusually strict. Neither witness can be:

• The designated health care agent or alternate agent
• The principal's spouse
• Anyone related by blood, marriage, or adoption
• An heir to any part of the principal's estate
• Anyone with a claim against the estate

The Care Facility Witness Trap

If your parent is signing in a hospital, nursing home, or assisted living facility, at least one of the two witnesses must not be a direct healthcare provider or an employee of a healthcare provider currently giving direct care to the principal. A notary who happens to be a facility employee can still notarize, but the witness restrictions apply separately.

This catches many families off guard. You can't just grab two nurses from the floor — at least one witness must be unconnected to the parent's current care.

Who Cannot Be Appointed as Health Care Agent

Under NDCC Section 23-06.5-04, your parent cannot appoint:

• Their treating healthcare provider
• A non-relative employee of their treating provider
• The operator of a long-term care facility where they reside
• A non-relative employee of that facility

Family members who work in healthcare but don't treat the parent directly are generally acceptable. But if your parent lives in an assisted living facility and the administrator is a family friend, that person cannot serve.

Copies Are Legally Valid

One of the most practical features of North Dakota's law: under NDCC Section 23-06.5-13, a copy of a health care directive is legally presumed to be a true and accurate copy of the original. Hospitals must give it the same legal effect as the original.

This means you can distribute copies to every clinic, hospital, and care facility without worrying about tracking down the original during an emergency.

Don't Confuse This with the Financial POA

The Health Care Directive covers medical decisions only. It does not give your agent authority over bank accounts, real estate, or government benefit applications. For financial authority, you need a separate Durable Power of Attorney under NDCC Chapter 30.1-30.

Most families in a care crisis need both. The North Dakota Power of Attorney & Guardianship Kit covers the complete legal authority package — financial POA, health care directive, and the step-by-step signing protocol for each, including the witness rules that trip up families in care facility settings.

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