North Dakota Living Will: How It Works Under State Law

If you're searching for a "living will" in North Dakota, you won't find a standalone document by that name in the state's statutes. That's because North Dakota combines what most people call a living will with a medical power of attorney into a single legal instrument: the Health Care Directive, governed by NDCC Chapter 23-06.5.

This distinction matters because if you draft a standalone "living will" using a form from another state, North Dakota healthcare providers may not recognize it.

Living Will vs. Health Care Directive in North Dakota

In common usage, a "living will" refers to a written document that specifies your treatment preferences if you become terminally ill or permanently unconscious — particularly your wishes about life-sustaining treatment.

North Dakota's health care directive does this and more. It has two functional parts:

Part I: Agent Appointment. You designate a healthcare agent who can make medical decisions on your behalf when you can't communicate. This is what other states call a medical power of attorney.

Part II: Treatment Instructions. You specify your preferences regarding life-prolonging treatments, including whether artificially administered nutrition and hydration should be continued, withheld, or withdrawn under specific clinical scenarios. This is the "living will" component.

You can complete either part independently, but most people complete both. An agent without instructions has to guess your wishes. Instructions without an agent leave no one authorized to interpret them in ambiguous situations.

Execution Requirements

North Dakota's health care directive has formal execution requirements that go well beyond simply signing the document:

Signature and date. The principal must sign and date the document.

Verification. The signature must be verified by either a notary public or two subscribing witnesses who are at least 18 years old.

Witness restrictions. If using witnesses, at least one cannot be a healthcare provider or employee of a provider currently delivering care to you. Neither witness can be your designated agent, spouse, blood relative, heir, creditor, or attending physician.

These restrictions under NDCC § 23-06.5-05 are designed to prevent conflicts of interest. Failing to meet them renders the directive legally invalid.

What You Can Specify About Treatment

North Dakota law specifically addresses several categories of end-of-life decisions:

Artificially administered nutrition and hydration. Under state law, healthcare providers must continue nutrition and hydration unless you have explicitly stated otherwise in your directive. This means a generic instruction to "withhold life-sustaining treatment" may not cover tube feeding unless you specifically address it.

CPR and resuscitation. You can specify whether you want cardiopulmonary resuscitation attempted.

Mechanical ventilation. You can instruct providers about the use of breathing machines.

Comfort care. You can ensure that pain management continues regardless of other treatment decisions.

The key point: be specific. Broad language like "no heroic measures" has no legal definition in North Dakota. Providers need clear, specific instructions they can follow without interpretation.

When Your Directive Takes Effect

Your health care directive activates only when two conditions are met:

1. You are unable to make or communicate your own healthcare decisions
2. Your attending physician has documented your incapacity

As long as you can communicate your wishes, your own decisions override everything in the directive. Your healthcare agent's authority is supplementary — it exists for the situations where you cannot speak for yourself.

Common Mistakes

Using a form from another state. Each state has different execution requirements. North Dakota's witness disqualification list is unusually extensive, and forms designed for other states won't account for these restrictions.

Leaving the nutrition and hydration section blank. In North Dakota, silence means continuation. If you want nutrition and hydration withheld under certain circumstances, you must state that explicitly.

Forgetting to distribute copies. Your directive should be on file with your healthcare agent, your physician, your local hospital, and your family. A valid directive that nobody can find when it's needed is functionally useless.

Only completing Part II. Treatment instructions without a designated agent leave gaps for situations your written instructions don't specifically address.

Connecting Your Healthcare and Financial Plans

A health care directive handles medical decisions, but it gives your agent zero authority over finances. If you're incapacitated, someone also needs to pay your medical bills, manage your insurance, and handle your property. That requires a separate financial power of attorney under NDCC Chapter 30.1-30.

The North Dakota Power of Attorney Kit covers both documents — the health care directive and the durable financial power of attorney — with execution checklists that walk you through North Dakota's specific witness qualifications and verification requirements.

See more North Dakota guides →