Maryland Hospital Advance Directive Form: What to Know Before You Sign

Every Maryland Hospital Must Ask About Your Advance Directive

Federal law requires hospitals to ask whether you have an advance directive at the time of admission. If you do not have one, they must offer you information about your rights and provide a form you can complete.

This is where the trouble starts. Hospital-provided advance directive forms are designed to fulfill the hospital's legal obligation to ask the question. They are not designed to capture the nuanced, specific preferences that protect you during a complex medical crisis.

What Hospital Forms Typically Look Like

MedStar Health, Johns Hopkins, Frederick Health, Adventist HealthCare — Maryland hospitals typically provide the standard Attorney General form or their own simplified version. These forms cover the basics:

• Naming a healthcare agent
• Specifying treatment preferences for three clinical states (terminal condition, persistent vegetative state, end-stage condition)
• Signature and witness sections

The forms are legally valid. They are also filled out in the worst possible environment for making life-altering decisions: under time pressure during hospital intake, often during a health scare, surrounded by clinical noise and emotional stress.

Three Problems with Hospital-Issued Forms

Problem 1: Rush conditions. Hospital intake teams have a checklist to complete. Your advance directive is one item on that checklist. The staff person handing you the form is not going to sit with you for an hour discussing whether you want a feeding tube if you develop late-stage Alzheimer's. They need the form signed and filed.

Problem 2: Institutional protection, not patient protection. Hospital forms are drafted by the institution's legal department. Their primary concern is ensuring the hospital has documentation that compliant procedures were followed. The form protects the hospital from liability — not necessarily your custom preferences.

Problem 3: Accidental revocation. If you already have a comprehensive advance directive at home but sign a new, simpler one during hospital admission, the new document may supersede the old one. Under Maryland law, executing a new advance directive revokes any prior version. A rushed hospital form could undo months of careful planning.

You Are Not Required to Use the Hospital's Form

This is the fact most patients do not know: you can bring your own legally executed advance directive to any Maryland hospital, and they must honor it. You are not obligated to fill out the hospital's version.

Any advance directive that meets the requirements of the Maryland Health Care Decisions Act — signed, dated, and witnessed by two adults following the statutory rules — is valid regardless of which form it is printed on. The hospital's form has no special legal status.

What to Do When Admitted

If you already have an advance directive: Bring a copy. Tell the intake staff that you have an existing advance directive and provide it for your medical record. Decline to sign a new form unless you are specifically updating your preferences.

If you do not have one: Do not feel pressured to complete the hospital's form during admission. You can take the form home, review it carefully, discuss your preferences with your family and physician, and return it later. The federal requirement is that the hospital offer you information — not that you complete the form on the spot.

If you need to update: If your circumstances have changed and you want to update your advance directive during a hospital stay, complete the new form carefully — including proper witnesses — and inform your previous healthcare agent that the old document is superseded.

The Better Approach: Arrive Prepared

The strongest position you can be in at any Maryland hospital is arriving with a completed, comprehensive advance directive already in your medical record, already uploaded to MyDirectives.com, and already in the hands of your healthcare agent.

The Maryland Advance Directive & Living Will Kit is designed to be completed at home, at your own pace, with clear instructions and the specific clinical scenarios that hospital forms skip. Complete it once, distribute it properly, and every future hospital admission becomes a simple matter of confirming that your documents are on file.

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