Indiana Senate Enrolled Act 204: How SEA 204 Changed Advance Directives

Senate Enrolled Act 204 is the most significant overhaul of Indiana's healthcare decision-making laws in decades. Enacted on July 1, 2021, with mandatory compliance starting January 1, 2023, SEA 204 replaced a fragmented system of separate documents with a single unified advance directive framework.

If you executed healthcare planning documents before 2023, your old documents remain valid. But if you are creating or updating your directive now, you need to understand what changed — because using pre-SEA 204 language in new documents can void your healthcare authority entirely.

What SEA 204 Consolidated

Before this law, Indiana maintained three separate types of healthcare planning documents:

1. Healthcare power of attorney
2. Healthcare representative appointment
3. Living will declaration

These documents were governed by different statutes, used different forms, and were frequently misunderstood by both consumers and healthcare providers. Families often had overlapping or contradictory documents, and hospitals struggled to determine which took precedence.

SEA 204 merged all three into a single "Advance Directive for Health Care Decisions" under Indiana Code § 16-36-7. One document now handles your Health Care Representative appointment, your living will declaration, and your specific treatment preferences.

The Critical Change for New Documents

The most important practical impact: general durable powers of attorney executed after December 31, 2022, can no longer legally grant healthcare decision-making authority using the old statutory language. If you had a general POA that included a clause like "including healthcare decisions," that clause is void in any document signed after the transition date.

This catches people who update their estate planning with a new general POA and assume it still covers medical decisions. It does not. Healthcare authority must now come from a properly executed advance directive under the new framework.

No Mandatory Form Language

Under the old system, Indiana provided specific statutory form templates that many people assumed were required. SEA 204 eliminated all mandatory form language.

You can now write your advance directive in plain English on any written or electronic medium. There is no required template, no government-issued form you must use, and no specific statutory phrases you must include. The legal validity comes from proper execution (signing, dating, witnessing or notarization), not from matching state-prescribed language.

This flexibility is a benefit, but it also means free templates downloaded from hospital websites or legal form aggregators may use any format — and many still distribute pre-2023 forms that split the directive into separate documents.

Remote Execution Provisions

SEA 204 legalized three methods of remote execution:

Live video conference. You and your witnesses or notary participate in a real-time audio-visual call. If signing paper counterparts, all pages must be compiled into a single composite document within 10 business days.

Telephonic execution. Available when video is physically impossible. Witnesses must verify your identity and capacity during the call, and the directive must state that telephonic interaction was used.

Electronic signatures. Valid under the new framework, enabling fully digital execution when combined with remote notarization.

These provisions were partly driven by pandemic-era needs but remain permanent features of Indiana law.

What Stays the Same

Several important rules carried over unchanged:

• You must be 18 or older (or an emancipated minor) with decisional capacity
• Validation requires either a notary or two qualified witnesses
• The pregnancy exception still renders living will declarations inoperable during pregnancy
• The default consent hierarchy under IC § 16-36-1-5 still applies when no HCR is designated
• Revocation can happen at any time by oral statement, written notice, or physical destruction

Documents executed under the old statutes before 2023 remain valid and enforceable. SEA 204 does not retroactively void properly executed pre-existing directives.

The Indiana Advance Directive & Living Will Kit is built on the current SEA 204 framework with templates that reflect the consolidated structure and execution methods.

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