Medical power of attorney in Maryland: how it works, how to sign
The short answer
In Maryland, you name a health care agent in an advance directive. It must be dated, signed and witnessed by two adults, with no notary needed. Your agent can't be a witness. If you name nobody, the law turns to a guardian, your spouse or domestic partner, adult children, parents, siblings, then a friend.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
Maryland calls the document an "advance directive," and the person you name is your "health care agent." This page covers how to sign one, who can't be your witness, how treatment wishes fit in, and what happens if you name nobody. It is part of our guides to estate planning by state. For the basics of the role, see what a medical power of attorney is.
How do I sign an advance directive in Maryland?
Maryland keeps this fairly simple. A written or electronic advance directive must be dated and signed by you, or by someone at your express direction (HG 5-602).
Then two witnesses sign it, in your physical or electronic presence. No notary is required.
That is different from Maryland's financial power of attorney, which needs a notary and two witnesses. Our Maryland power of attorney guide covers that document.
Maryland also recognizes an oral advance directive. You can tell your attending physician, physician assistant or nurse practitioner your wishes, with one witness present, and it is written into your medical record. A written one is still easier for everyone to find later.
Who can't be my witness?
Most competent adults can witness, including a facility employee or your own doctor acting in good faith. Two limits apply (HG 5-602):
| Person | Can be a witness? |
|---|---|
| The person you name as your health care agent | No |
| Someone who would inherit from you or gain financially from your death | Yes, but at least one of your two witnesses must not be such a person |
| A friend or neighbor who gains nothing from your estate | Yes |
| A health care facility employee or your physician | Yes, acting in good faith |
The easy path: ask two friends or neighbors who aren't in your will.
There is also a limit on who can be your agent. Owners, operators and employees of a facility treating you, and their close relatives, generally can't serve.
Is there an official Maryland form?
Yes, an optional one. It is called "Maryland Advance Directive: Planning for Future Health Care Decisions" (HG 5-603). The form itself says other forms are also valid.
It has two parts. Part I names your health care agent. Part II records your treatment preferences. You can fill in either part or both.
When does my agent's authority start?
Unless your document says otherwise, it starts when your attending physician and a second physician certify in writing that you can't make an informed decision. If you are unconscious or can't communicate, the second physician isn't needed.
Your agent is a fiduciary: legally required to act in your interest and follow what you wrote. In daily terms, that means talking with your doctors and agreeing to or declining treatment in light of your wishes.
Your financial power of attorney doesn't cover any of this. Maryland's power of attorney law leaves health care decisions out (ET 17-109).
Do I need a living will too?
Not as a separate document. Maryland doesn't have a separate living will statute. Your treatment instructions go into the same advance directive and are signed the same way: two witnesses, no notary.
That is what Part II of the optional form is for. It covers your wishes if you have a terminal condition, are in a persistent vegetative state, or have an end-stage condition. Our post on health care power of attorney vs living will explains how naming a person and writing down wishes work together, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
Maryland law picks for you. If you are certified as unable to make an informed decision and you have no health care agent (or your agent isn't available), these people may decide, in this order (HG 5-605):
| Order | Who can decide | Notes |
|---|---|---|
| 1 | A guardian, if a court appointed one | |
| 2 | Your spouse or domestic partner | Not a spouse after a separation agreement or a divorce filing |
| 3 | An adult child | |
| 4 | A parent | |
| 5 | An adult brother or sister | |
| 6 | A friend or other relative | Must give the doctor a sworn affidavit |
A lower group is used only if everyone in the higher group is unavailable. Anyone under a protective order protecting you is ruled out.
A friend can serve, but only at the end of the line and only with paperwork. The friend must be competent and give your attending physician an affidavit. It must say they are a relative or close friend and give specific facts showing regular contact with you. The contact must be enough to know your activities, health and personal beliefs.
Whoever decides must follow your wishes, or your best interest if your wishes aren't known. If people in the same group disagree and you are in a hospital, the case goes to the hospital's patient care advisory committee.
Our post on medical decisions without a power of attorney compares other states, and our who decides for me page walks through the question. If the person who really knows your wishes is a friend, naming them as your health care agent moves them to the front.
Here is a typical case, a composite. Barbara is 73, widowed, and lives in Silver Spring. Her son lives in Texas and calls on Sundays. Her neighbor Ellen drives her to appointments and knows what she would want. Barbara names Ellen as her health care agent and her son as backup.
How do I choose my agent?
The practical questions matter most. Is the person willing? Can they get to the hospital? 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.
When your health papers are done, our Maryland probate guide covers what happens to your home and savings later.
Common questions
Does a medical power of attorney need to be notarized in Maryland?
No. A Maryland advance directive needs your dated signature and two witnesses. No notary is required.
Can a family member witness my Maryland advance directive?
Yes, unless they are your health care agent. But at least one of your two witnesses must not stand to inherit from you or gain financially from your death.
Who makes medical decisions in Maryland if there's no advance directive?
A guardian if there is one, then your spouse or domestic partner, an adult child, a parent, an adult sibling, and finally a friend or other relative. A lower group decides only if everyone above is unavailable.
Can a close friend make medical decisions for me in Maryland?
Yes, but only last in line, and only after giving your doctor a sworn affidavit showing regular contact with you. Naming the friend as your health care agent puts them first.
Does Maryland have a living will?
Not as a separate document. Your treatment wishes go in the same advance directive, signed the same way. The optional state form has a part for them.
Sources
This page is general information, not legal or financial advice. Laws vary by state.