Medical power of attorney in Hawaii: how it works, how to sign
The short answer
In Hawaii, you name a health care agent in an advance health-care directive. You sign and date it, then either two qualifying witnesses sign or you acknowledge it before a Hawaii notary. If you name nobody, Hawaii has no ranked list: your family and close friends must agree on one person to decide.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
Hawaii answers it in an "advance health-care directive," which can include a power of attorney for health care. This page covers how to sign one, who can't be your witness, where your end-of-life wishes go, and Hawaii's unusual rule for when you name nobody. It is part of our estate planning guides by state. For the basics of the role, see what a medical power of attorney is.
What is Hawaii's medical power of attorney called?
Hawaii's umbrella document is the advance health-care directive. Part of it can be a "power of attorney for health care," where you name your agent. Hawaii's optional form calls that part a "durable power of attorney for health-care decisions" (HRS 327E-3).
You don't have to use the state's form. A different form with the same substance works (HRS 327E-16). A directive that was valid where you signed it in another state is valid in Hawaii too.
Your agent's authority starts only when you are found to lack capacity, unless your document says otherwise.
How do I sign it?
Here is what Hawaii requires for a power of attorney for health care (HRS 327E-3):
- It must be in writing and dated.
- You sign it.
- Then either two witnesses sign, each of whom saw you sign or heard you acknowledge your signature, or you acknowledge it before a notary public in Hawaii.
You choose one path or the other. Many people find the notary simpler, because the witness rules take some thought.
Hawaii's financial power of attorney is different. The law requires only your signature, though a notary is wise. Our Hawaii power of attorney guide covers that document.
Who can't be my witness?
If you use witnesses instead of a notary, Hawaii rules out several people (HRS 327E-3):
| Person | Can be a witness? |
|---|---|
| The person you name as your health care agent | No |
| A health care provider | No |
| An employee of a health care provider or facility | No |
| A relative by blood, marriage or adoption | Only one of the two |
| Someone who would inherit from you, by will or by law | Only one of the two |
| A friend or neighbor who is none of the above | Yes |
In plain terms: at least one witness must be someone who isn't related to you and isn't in line to inherit. Two friends or neighbors is the easy path.
One more rule: unless they are related to you, your agent can't be an owner, operator or employee of the facility where you are getting care.
What can my agent decide?
Your agent makes the health care decisions you would make if you could. Your agent is a fiduciary: legally required to act in your interest and follow what you wrote.
In day-to-day terms, that usually means talking with your doctors, reading your chart, and agreeing to or declining a test, a surgery or a new medicine in light of your wishes.
Do I need a separate living will?
Not in Hawaii. The old living will law was repealed in 1999 (HRS chapter 327D note). Today your end-of-life wishes go in an "individual instruction."
An individual instruction can be written or even spoken. It can sit inside your advance health-care directive, in Part 2 of the state's form (HRS 327E-3). Writing it down, in the same document as your agent, is the clearest way to make sure it is followed.
Our post on health care power of attorney vs living will explains how the two ideas fit, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
This is where Hawaii stands out. There is no ranked list (HRS 327E-5).
First, you can name a surrogate simply by telling your supervising health care provider. You can also rule someone out the same way.
If you haven't, and you have no agent or guardian available, your doctor gathers the "interested persons." They must try to agree on one of them to serve. The law says it should be the person with a close relationship who is most likely to know your current wishes.
| Who counts as an interested person in Hawaii | Ranked ahead of the others? |
|---|---|
| Your spouse, unless legally separated or estranged | No |
| Your reciprocal beneficiary | No |
| Any adult child | No |
| Either parent | No |
| An adult brother or sister | No |
| An adult grandchild | No |
| Any adult who has shown special care and concern for you and knows your values | No |
A close friend can serve in Hawaii, if the group agrees and the friend fits that last row (HRS 327E-2). The chosen surrogate signs a written declaration for the provider.
If the group can't agree, any of them who took part may ask a court for guardianship. A surrogate you didn't choose also faces limits on stopping tube feeding: two physicians must certify the conditions in the statute first.
Consensus sounds gentle, but it can stall when a son on the mainland and a friend down the road see things differently. Naming a health care agent avoids the meeting altogether. Our page on who decides for you shows how this works, and the 50-state guide to default decision-makers compares other states.
Here is a typical case, a composite. Ruth is 74, divorced, and lives in Kailua. Her daughter lives in Denver. Her neighbor Mae drives her to every appointment and knows what she would want. Ruth names Mae as her health care agent and her daughter as backup, so nobody has to reach a consensus in a hospital waiting room.
How do I choose my agent?
Once the signing is done, the practical questions matter most. Is the person willing? Can they get to the hospital, even from another island? Will they follow your wishes even when they'd choose differently?
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named a backup in case they can't.
Our post on how to choose a medical power of attorney has more questions to ask.
Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as the backup to someone you choose.
Once your health papers are done, our Hawaii probate guide covers what happens to your home and savings later.
Common questions
Does a medical power of attorney need to be notarized in Hawaii?
No, but it can be. You either have two qualifying witnesses sign it or acknowledge it before a Hawaii notary. Either path is valid.
Can a family member witness my Hawaii advance health-care directive?
One of your two witnesses can be a relative. The other must be someone who isn't related to you and wouldn't inherit from you. Your agent and health care workers can't witness at all.
Who makes medical decisions in Hawaii if there's no advance directive?
Hawaii has no ranked list. Your spouse or reciprocal beneficiary, adult children, parents, adult siblings, adult grandchildren and qualifying close friends must try to agree on one surrogate. If they can't, one of them can seek guardianship.
Can a close friend make medical decisions for me in Hawaii?
Yes. A friend who has shown special care and concern for you and knows your values counts as an interested person and can be chosen as surrogate. Naming the friend as your health care agent is more certain.
Sources
- HRS 327E-3: Advance health-care directives (Hawaii State Legislature)
- HRS 327E-16: Optional form (Hawaii State Legislature)
- HRS 327E-5: Health-care decisions; surrogates (Hawaii State Legislature)
- HRS 327E-2: Definitions (Hawaii State Legislature)
- HRS chapter 327D: Medical Treatment Decisions, repealed (Hawaii State Legislature)
This page is general information, not legal or financial advice. Laws vary by state.