Hawaii Living Will: What It Covers and How It Differs From an Advance Directive

People search "Hawaii living will" expecting to find a standalone form — a document that says "if I'm terminally ill, don't keep me on life support." What they find instead is confusing: Hawaii doesn't have a separate living will statute. The state rolled everything into one document under HRS Chapter 327E, the Uniform Health-Care Decisions Act.

That matters because it changes what you need to fill out, who signs it, and what it actually controls.

Hawaii Merged Everything Into One Document

Most mainland states split end-of-life planning into two forms: a living will (treatment instructions) and a healthcare power of attorney (agent designation). Hawaii combined both into a single Advance Health-Care Directive.

Part 1 of the statutory form under HRS Section 327E-16 lets you designate a healthcare agent — the person who makes decisions when you cannot. Part 2 lets you write individual instructions about the treatments you want or refuse. You can fill out one part, the other, or both.

If you only want treatment instructions without naming an agent, you fill out Part 2 alone. That is functionally a living will. But it is executed, witnessed, and enforced under the same statute as the full directive.

What a Hawaii Living Will Actually Controls

Your individual instructions under Part 2 bind your healthcare providers when your primary physician determines you lack capacity. You can specify:

• Whether you want life-sustaining treatment if you have a terminal condition
• Whether you want artificial nutrition and hydration
• Specific treatments you want refused or continued under any circumstances
• Preferences about pain management, even if it might hasten death
• Your wishes regarding organ donation

These instructions override your healthcare agent's judgment. If you wrote "no mechanical ventilation under any circumstances" and your agent later tells the hospital to intubate, the hospital must follow your written instructions — not the agent's verbal request.

The Critical Difference: Instructions vs. POLST

An advance directive with treatment instructions tells the hospital what you want in the future. A POLST (Provider Orders for Life-Sustaining Treatment) is a set of active medical orders signed by your physician that go into effect immediately.

The advance directive is your voice. The POLST is your doctor's order translating that voice into clinical action. EMS responders on the Big Island or Kauai follow the bright lime-green POLST form — they are not trained to interpret an advance directive at the scene of an emergency.

If you only have a living will and no POLST, paramedics will default to full resuscitation. If you have a POLST but no advance directive, your broader treatment preferences are undocumented and your family may end up in the consensus surrogate process when longer-term decisions arise.

You need both.

Execution Requirements

Because Hawaii's living will is part of the Advance Health-Care Directive, it follows the same execution rules under HRS Section 327E-3:

• You must be an adult with capacity at the time of signing
• You need either two qualified witnesses or a notary public
• Neither witness can be your healthcare provider or a facility employee
• At least one witness must be unrelated to you and have no estate claim
• Your designated healthcare agent (if you named one in Part 1) cannot serve as a witness

Hawaii does not accept electronic signatures on advance directives. The document must be printed and signed with wet ink. This catches people who download a template online and assume a digital signature will work — it won't, and the hospital's legal department will reject it during intake.

Can You Revoke a Living Will in Hawaii?

Yes, and it's easier than creating one. Under HRS Section 327E-4, you can revoke your advance directive — or just the treatment instructions portion — at any time by:

• Signing a written revocation
• Physically destroying the document
• Verbally telling your healthcare provider you revoke it

A verbal revocation works even if you lack the capacity to create a new directive, as long as you can communicate the intent to revoke. Your healthcare provider must document the revocation in your medical record.

If you create a new advance directive, it automatically revokes any prior directive to the extent they conflict.

Making Your Treatment Instructions Count

Vague instructions create the same problems as no instructions. Writing "I don't want extraordinary measures" gives your healthcare team nothing to act on — the term has no clinical definition. Specify the actual treatments: mechanical ventilation, CPR, dialysis, tube feeding, IV antibiotics for secondary infections.

The Hawaii Advance Directive & Living Will Kit includes a values worksheet that translates your preferences into specific, enforceable clinical language — so your living will actually does what you think it does.

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