Medical power of attorney in Tennessee: how it works, how to sign

The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?

Tennessee calls the paper an "advance directive." It can name a health care agent, record your treatment wishes, or both. This page covers how to sign one, who can't be your witness, how a living will fits in, and what happens if you never name anyone. 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.

What is the document called in Tennessee?

Tennessee's Health Care Decisions Act uses the term "advance directive." That word covers two things: a living will, and a durable power of attorney for health care (T.C.A. 68-11-1802).

The person you name is your "agent." You name them through a "power of attorney for health care." Many people put both parts in one document.

How do I sign one in Tennessee?

The rules are short. The advance directive must be in writing and signed by you. Then it needs one of these (T.C.A. 68-11-1803):

• A notary, or
• Two competent adult witnesses.

If you use witnesses, the document must include an attestation clause. That is a short statement in which the witnesses confirm they meet the rules below.

You don't need a lawyer's form. Tennessee's statute directs the state board that licenses health care facilities to publish model advance directive forms (T.C.A. 68-11-1805). Any document that meets the signing rules works.

Who can't be my witness?

Two rules apply when you use witnesses instead of a notary (T.C.A. 68-11-1803):

Put simply: at least one of your two witnesses must be someone who isn't family and won't inherit from you. The easiest path for many people is a notary. If you use witnesses, two friends or neighbors who aren't in your will make it simple.

Tennessee's financial power of attorney follows a different set of rules. Our Tennessee power of attorney guide covers that document.

Do I need a living will too?

Many people sign both. A power of attorney for health care names a person. A living will writes down your wishes about treatment, so that person isn't guessing.

In Tennessee, a living will can be part of your advance directive, signed the same way (T.C.A. 68-11-1803). An older law, the Right to Natural Death Act, also stays on the books. A declaration under it is signed and then notarized or witnessed by two adults, with the same witness limits and an attestation clause (T.C.A. 32-11-104).

That older law has a sample form (T.C.A. 32-11-105). Its witness statements are stricter than the statute requires, so if you use it, read the witness lines closely. Our post on health care power of attorney vs living will explains how the two work together, and treatment preferences helps you think through what to write.

Who decides if I haven't named anyone?

Tennessee has a useful rule here. You can name a surrogate simply by telling your supervising health care provider, out loud or in writing (T.C.A. 68-11-1806). A signed document is still clearer, but this matters if you are already in the hospital.

If you haven't named an agent or a surrogate, and no guardian is available, the provider picks a surrogate. That person must be an adult who:

• has shown special care and concern for you,
• knows your personal values,
• is reasonably available, and
• is willing to serve.

The provider weighs who can best follow your wishes, who has seen you regularly, and who can visit and meet the care team in person. It considers people in this order:

So a close friend can serve, but last. There is no majority vote among several children. The provider chooses the best qualified person.

A few more rules apply. Someone under a court order to stay away from you can't serve. Your treating providers, their employees and the facility's operators can't serve unless they are related to you. If nobody qualifies, the physician may decide after consulting an ethics process or with a second independent physician agreeing.

For stopping artificial nutrition and hydration, a surrogate's decision needs certification from your physician and a second independent physician. A provider may also ask the surrogate to sign a sworn statement of their authority.

Our post on medical decisions without a power of attorney compares how other states handle this, and the 50-state guide to default decision-makers has the full list. You can also use our who decides for me tool to see your own state's order.

Here is a typical case, a composite. Dorothy is 74, widowed, and lives in Chattanooga. Her son lives in Phoenix and her niece Ellen, an hour away, drives her to every appointment. Without a document, a provider would look to her son first. Dorothy names Ellen as her health care agent and her son as backup.

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? Will they follow your wishes even when they'd choose differently?

A short checklist:

• 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.

Your agent is a fiduciary: legally required to act in your interest and follow what you wrote. 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 members choose who serves and in what order.

Once your health papers are done, our Tennessee probate guide covers what happens to your home and savings later.

Common questions

Does a medical power of attorney need to be notarized in Tennessee?

Not necessarily. It must be either notarized or signed before two competent adult witnesses. If you use witnesses, your agent can't be one, and at least one must be unrelated to you and not an heir.

Can a family member witness my Tennessee advance directive?

Yes, as one of the two witnesses, as long as the other witness is not related to you and won't inherit from you. Your agent can never be a witness.

Who makes medical decisions in Tennessee if there's no power of attorney?

Your provider picks a surrogate who cares about you, knows your values and is available. It considers your spouse first, then an adult child, a parent, a sibling, other relatives, and finally another adult such as a close friend.

Can I name a surrogate without signing anything?

Yes. Tennessee lets you name a surrogate by telling your supervising health care provider, orally or in writing. A signed advance directive is still the clearest way to make your choice stick.

Sources

• T.C.A. 68-11-1802: Definitions (FindLaw copy, current as of January 2, 2024)
• T.C.A. 68-11-1803: Advance directives; execution (FindLaw copy)
• T.C.A. 68-11-1805: Model forms (FindLaw copy)
• T.C.A. 68-11-1806: Surrogates (FindLaw copy)
• T.C.A. 32-11-104: Living will declaration; execution (FindLaw copy)
• T.C.A. 32-11-105: Living will form (FindLaw copy)