Vermont Advance Directive vs Living Will: What's the Difference?

In most states, you sign two separate documents: a living will that records your treatment preferences, and a healthcare proxy (or medical power of attorney) that names someone to make decisions for you. Vermont combined these into a single document.

Under 18 V.S.A. § 9703, the advance directive handles everything. It names your healthcare agent, records your treatment instructions, and can include provisions for organ donation, mental health care, and disposition of remains — all in one legal instrument.

Why Vermont Merges Them

The practical reason is coordination. When a patient arrives at a hospital unconscious, staff need two pieces of information: who can make decisions, and what the patient wanted. In states with separate documents, confusion arises when the living will says one thing and the healthcare proxy holder wants something different. Whose instructions control?

Vermont avoids this by putting both elements in a single document signed under a single set of execution rules. The healthcare agent's authority is shaped by the treatment preferences written in the same directive — they work together, not in tension.

What Each Component Covers

The healthcare agent appointment (what other states call a "healthcare proxy" or "medical power of attorney"): You name a primary agent and at least one alternate. Your agent has broad authority to consent to, refuse, or withdraw treatment on your behalf when you lack decision-making capacity. You can limit this authority by specifying conditions or treatments that the agent cannot authorize.

The treatment preferences (what other states call a "living will"): You document your wishes about life-sustaining treatment — CPR, mechanical ventilation, artificial nutrition and hydration, dialysis — for specific scenarios like terminal illness, permanent vegetative state, or irreversible coma. The more specific your instructions, the less your agent has to guess.

Additional provisions Vermont allows:

• Organ and tissue donation preferences
• Mental health and psychiatric care decisions (available on the VEN Long Form)
• Authorization for the agent to make decisions over your active objection during incapacity
• Preferences about the disposition of your remains

Where the "Medical Power of Attorney" Confusion Comes From

When people search for "Vermont medical power of attorney," they're usually looking for a way to name someone to make healthcare decisions. That document is the advance directive — there's no separate medical POA form in Vermont.

The confusion intensifies because Vermont has a completely separate document for financial powers of attorney, which operates under different rules. A financial POA requires notarization under the 2023 Uniform Power of Attorney Act and needs to be recorded at the town clerk's office if it covers real estate. A healthcare advance directive requires two witnesses but no notary.

These are not interchangeable. Your healthcare agent (named in the advance directive) has no authority over your bank accounts or property. Your financial agent (named in the financial POA) has no authority over your medical care.

The Healthcare Proxy in Practice

Vermont uses the term "healthcare agent" rather than "healthcare proxy," but the function is identical. Your agent steps in when a clinician determines you lack capacity to make your own medical decisions. Their authority includes:

• Consenting to or refusing medical treatment
• Accessing your medical records
• Selecting or discharging healthcare providers
• Making decisions about experimental treatment or clinical trials

One important limitation: your healthcare agent cannot invoke Act 39 (Vermont's medical aid in dying law) on your behalf. That requires contemporaneous capacity and physical self-administration.

One Document, One Execution

The advantage of Vermont's combined approach is simplicity: you execute one document with two witnesses (no notary), register it once with the Vermont Advance Directive Registry (VADR), and you're covered for both agent appointment and treatment preferences.

The Vermont Advance Directive & Living Will Kit walks you through both components in a single guided process, with a witness eligibility checklist and VADR registration instructions built in.

See more Vermont guides →