Connecticut Advance Directive Guide

A Connecticut advance directive comes in three statutory forms, and you may sign any of them at 18 or older. Conn. Gen. Stat. § 19a-575 carries health care instructions, § 19a-577 appoints a health care representative, and § 19a-575a combines both on one page. Sign, date, and have at least two witnesses sign. Connecticut asks for no notary.

Two Connecticut answers rarely appear on national form sites, and both change what you should do this week. Your directive stays inert until somebody hands it to the doctor treating you. And if you never sign one, no spouse, child, or parent inherits the power to decide. This guide walks through chapter 368w as a planning map. Confirm anything touching your own care with a licensed Connecticut attorney or your own physician. Money and property run on a different instrument, so read this alongside the Connecticut power of attorney guide.

Three Documents, One Chapter

Connecticut folded the old health care agent and the old power of attorney for health care into a single office in 2006. The decider is now a health care representative. Anything you read that says Connecticut health care agent is describing a document signed before October 1, 2006, and § 19a-580f keeps those older papers alive.

Each of the three sections prints a form, and none of the three mandates it. Sections 19a-575 and 19a-575a both say the document may follow the printed form in substance. Section 19a-577 goes further and says the document may, but need not be, in that form. So a paper that meets the signing rules is good even when the wording wanders.

The combined § 19a-575a form does two things most states keep in separate envelopes. It designates a conservator of the person and a successor conservator for your future incapacity, waiving bond for both in any jurisdiction, and it carries a document of anatomical gift that takes effect at death. Signing it once covers ground that would otherwise take three appointments.

How to Sign One

The execution rules are short. Any person 18 or older signs and dates the document, and at least two witnesses sign. For an appointment, § 19a-576(a) adds that you sign in the presence of two adult witnesses who also sign the document.

Three points people get wrong:

• A notary adds nothing to validity. The jurat printed under the § 19a-575a witness block supports the optional proof affidavit in § 19a-578(a), where your attesting witnesses may swear to the facts they would testify to in court, and a court then accepts that sworn statement as if it had been taken there. Useful, never required.
• The person you appoint may not witness. Section 19a-576(a) bars your representative from acting as a witness and from signing the document at all. That is the only categorical witness bar in the chapter, so a relative or a nurse who is not your representative is not disqualified here.
• Facility residents follow an extra rule. If you live in a facility operated or licensed by the Department of Mental Health and Addiction Services, at least one witness must be unaffiliated with the facility and at least one must be a physician, advanced practice registered nurse, or licensed clinical psychologist with specialized training in treating mental illness. Section 19a-576(c) applies the same pattern, with training in developmental disabilities, to Department of Developmental Services facilities.

Chapter 368w says nothing about electronic signatures or remote witnessing in either direction. Keep it on paper with both witnesses in the room.

Who Can Serve as Your Representative

Most adults qualify. Section 19a-576 rules out three groups:

• An operator, administrator, or employee of a hospital, residential care home, rest home with nursing supervision, or chronic and convalescent nursing home, where you are a patient or resident of one of those facilities or have applied for admission, unless that person is related to you by blood, marriage, or adoption.
• An administrator or employee of a government agency that is financially responsible for your medical care, subject to the same family exception.
• Your own attending physician or advanced practice registered nurse, who may not hold both roles for you at once.

Name an alternative inside the same document. Both statutory appointment forms carry the line, and it costs nothing to fill in.

Your Directive Does Nothing Until a Doctor Holds It

This is the Connecticut trap, and it is written plainly in § 19a-579. A living will or an appointment of a health care representative becomes operative when the document is furnished to the attending physician or advanced practice registered nurse and that practitioner determines you are incapacitated. Both halves, or nothing happens.

A perfectly signed directive in a fireproof box is a piece of paper. Give copies to your representative, your alternative, and your doctor, and ask that a copy go into your chart. Section 19a-578(b) backs you up: a physician or other provider furnished with a copy has to make it part of your medical record, and has to record oral communications about your care that come from you, your representative, your guardian, your conservator, your next of kin, or a person you designated under § 1-56r.

Incapacitated has a statutory meaning under § 19a-570(7). You are unable to understand and appreciate the nature and consequences of health care decisions, including the benefits and disadvantages of treatment, and unable to reach and communicate an informed decision about it.

Connecticut does not make a written incapacity certificate a precondition, which is where content copied from other states goes wrong. Section 19a-579 instead gives your representative a right to ask: at any time after the appointment, the practitioner must disclose that determination of incapacity in writing on the representative's request. Tell your representative to make that request and keep the answer.

Connecticut Gives Your Family No Default Authority

Here is the sharpest reason to sign. Chapter 368w contains no default surrogate statute. No spouse-first rule, no ranked consent order, nothing that hands a daughter the power to refuse a ventilator because she is the daughter.

Section 19a-570(10) does print ranked classes, and that is what fools people. Next of kin means the spouse, then an adult son or daughter, then either parent, then an adult brother or sister, then a grandparent. Connecticut uses that definition in exactly three places, none of which grants authority to consent. Section 19a-571 tells the attending practitioner to consult next of kin when working out an incapacitated patient's wishes about life support. Section 19a-578(b) requires their oral reports to go in the chart. Section 19a-580 requires reasonable efforts to notify them before life support comes off. Consultation, recording, notice. Any page that hands you a Connecticut family consent hierarchy is describing another state.

When a real decider is needed and nobody was appointed, the route runs through court. A Probate Court conservator of the person appointed under § 45a-656 may be given authority to consent to medical care, must use the least restrictive means of intervention, and must make all reasonable efforts to find out what the conserved person wanted. That takes a petition, a hearing, and a physician's report. Signing a § 19a-577 appointment takes ten minutes. For what the court process looks like, read what happens with no directive.

Section 19a-572 adds a quiet protection worth knowing. Skipping the paperwork creates no presumption about your wishes, so a hospital may not treat a missing living will as evidence that you wanted everything done.

What Your Representative Can Decide

Once the directive is operative, your representative may make any and all health care decisions for you, including accepting or refusing any treatment, service, or procedure used to diagnose or treat your physical or mental condition, and providing, withholding, or withdrawing life support systems.

One carve-out sits inside both forms. The authority runs except as otherwise provided by law, such as for psychosurgery or shock therapy as defined in § 17a-540. Those two treatments answer to their own statute.

Your representative is not free to improvise. The forms direct a decision in accordance with your wishes as stated in the document or as otherwise known to the representative. Where your wishes are unclear, or a situation arrives that you never anticipated, the representative may decide in your best interests based on what is known of your wishes. That sentence is the reason to talk your values through with the person you name, rather than handing over a signed page and changing the subject.

Life Support Runs on Separate, Stricter Rules

Withholding or removing a life support system has its own test in § 19a-571(a), and it applies whether or not you signed anything. A physician, advanced practice registered nurse, or licensed medical facility acts without civil or criminal exposure when three conditions hold:

1. The decision rests on the best medical judgment of the attending physician or advanced practice registered nurse under the usual and customary standards of medical practice.
2. That practitioner deems you to be in a terminal condition, or, in consultation with a physician qualified to make a neurological diagnosis who has examined you, deems you permanently unconscious.
3. That practitioner has considered your wishes about withholding or withdrawal.

Count the doctors. A terminal condition needs one practitioner. Permanent unconsciousness needs two, and the second must be qualified to make a neurological diagnosis and must have examined you.

Where neither finding is made, the statute sets a floor: beneficial medical treatment including nutrition and hydration must be provided. Comfort care and pain alleviation must be provided in all cases under § 19a-573(a), whatever else is happening.

Pregnancy: The Repealed Rule and the Election That Replaced It

Connecticut used to suspend a directive during pregnancy. Section 19a-574 was repealed effective May 24, 2018 by Public Act 18-11. The section still prints a normal-looking catchline on the state's own site, and its entire body now reads that it is repealed, so treat any article citing it as operative law with suspicion.

The same act wrote a three-option election into both statutory forms. You check one: accept life support systems if your doctor believes doing so would allow your fetus to reach a live birth, apply the document without modifications, or write alternative instructions of your own. Verify that the form in front of you carries that election, because older circulating PDFs do not.

Revoking: Two Rules, Not One

The asymmetry here is the single most common Connecticut mistake.

Two follow-on rules. Revoking the appointment does not by itself revoke your living will, per § 19a-575a(e). And a person who carries out a directive without knowing about a revocation faces no civil or criminal liability and no discipline for unprofessional conduct, under §§ 19a-575a(d) and 19a-579a(c). Tell your doctor and your representative when you change something, in writing, and collect the old copies.

Nothing in chapter 368w expires. Your directive stands until you revoke it, so review it after a marriage, a divorce, a move, or a hard diagnosis rather than on a calendar.

Conservators, Old Papers, and Out-of-State Forms

Your representative outranks a conservator. Under § 19a-580e, a conservator must comply with your health care instructions and other wishes expressed while you had capacity, and may not revoke your advance directive unless the appointing court expressly authorizes it. Absent a court order to the contrary, your representative's decision about health care, or about the disposition of the body after death, takes precedence over the conservator's, subject to three narrow exceptions tied to criminal commitment and psychiatric medication orders.

Older Connecticut documents keep working. Section 19a-580f preserves an advance directive properly executed before October 1, 2006 with the same force as one signed today, keeps a pre-2006 appointment of a health care agent effective under the law as it stood then, and preserves a pre-2006 power of attorney for health care decisions under former § 1-54a.

Directives signed elsewhere travel well. Section 19a-580g treats health care instructions or an appointment of a health care proxy executed under another state's law, or in a foreign country, as validly executed here when they comply with that law or with Connecticut's and are not contrary to Connecticut public policy. A provider may rely on the document based on a court order, a notarized statement that it is valid where made, or the provider's own good faith legal analysis. Signing a fresh Connecticut document anyway removes the argument.

MOLST and DNR Orders Are Medical Orders

Neither one is an advance directive, and neither replaces yours.

A do not resuscitate order under § 19a-580d is written by a licensed physician or advanced practice registered nurse for a particular patient, and the Department of Public Health adopts the regulations covering transfer between institutions, emergency medical services, and bracelets.

A medical order for life-sustaining treatment under § 19a-580h is a written order by a physician, advanced practice registered nurse, or physician assistant that carries out a patient's request when a practitioner has determined the patient is approaching the end stage of a serious, life-limiting illness or lives in advanced, chronic progressive frailty. The Commissioner of Public Health runs a state-wide MOLST program. Taking part is voluntary, and the patient or the patient's legally authorized representative documents agreement by signing the form. Public Act 24-68 deleted the witness-signature requirement effective May 28, 2024, so any guidance telling you a MOLST form needs a witness is stale. Ask your care team how a MOLST would sit alongside your directive.

When a Provider Will Not Comply

An attending physician or health care provider who is unwilling to follow your wishes must, as promptly as practicable, take all reasonable steps to transfer your care to a physician or provider who will comply (§ 19a-580a). Chapter 368w frames the answer as a transfer duty and prints no separate institutional conscience clause.

Nobody may pressure you into signing. Section 19a-580b bars any physician, provider, or health care insurer from requiring a living will or an appointment as a condition of treatment or of receiving benefits. The section states the prohibition and names no crime, so a violation is not a criminal matter on the face of the statute.

Disputes go to the Probate Court for the district where the person is domiciled or located at the time of the dispute, under § 19a-580c. Connecticut abolished county government in 1960, so there is no county probate court; § 45a-2 sets 54 probate districts covering the 169 towns, and you can find yours through the Connecticut Probate Court directory. That court hears disputes over the meaning or application of these sections, over your representative's capacity, and over claims that the named representative would interfere with treatment. Where your wishes reached the room by something other than a § 19a-575 or § 19a-575a document, the court weighs whether there is clear and convincing evidence of the communication. A person whose appointment was revoked has standing to challenge that revocation there.

A Connecticut Signing Sequence

1. Pick the document. The combined § 19a-575a form suits most people, because one signing covers instructions, a representative, a conservator designation, and an anatomical gift.
2. Ask your first choice and your alternative before you write their names down, and talk through what a good outcome looks like to you.
3. Sign and date in front of two adult witnesses who also sign, and keep the person you appointed off the witness lines.
4. Skip the notary unless you want the § 19a-578(a) proof affidavit, which your witnesses swear separately.
5. Check the pregnancy election if the form has one, and cross out and initial any life support system you do want administered.
6. Hand copies to your doctor, your representative, and your alternative, and confirm a copy landed in your medical record. Until that happens, § 19a-579 leaves the document inert.
7. Pair it with a durable power of attorney so somebody can pay your bills as well as answer your doctor.
8. Review after a marriage, divorce, move, or new diagnosis, and collect old copies whenever you replace it.

The medical half is only one document in a wider plan. The Connecticut power of attorney guide covers the money, a Probate Court conservator of the person covers the court route when nobody was appointed, and Connecticut estate planning basics lays out the rest of the document set. The Connecticut probate and estate directory ties the state pages together.

Frequently Asked Questions

Does a Connecticut advance directive need to be notarized?

No. Sections 19a-575 and 19a-575a each ask for a document signed and dated by the maker with at least two witnesses, and § 19a-576(a) adds that an appointment of a health care representative is signed in the presence of two adult witnesses who also sign. Nothing in chapter 368w makes a notary a condition of validity. The notary line printed at the bottom of the § 19a-575a form belongs to the optional proof affidavit of § 19a-578(a), which helps a court accept the witnesses' testimony later and is not part of signing.

Who makes medical decisions in Connecticut if I have no advance directive?

No relative gets that power automatically. Chapter 368w contains no default family surrogate statute. The ranked next-of-kin classes in § 19a-570(10) run spouse, adult son or daughter, either parent, adult brother or sister, grandparent, and Connecticut uses that list only to consult about your wishes under § 19a-571, to record what family reports under § 19a-578(b), and to give notice under § 19a-580. When someone actually needs authority to consent, a family member has to ask the Probate Court for the district to appoint a conservator of the person under § 45a-656.

When does a Connecticut health care representative's authority start?

Two things have to happen under § 19a-579. The document must be furnished to your attending physician or advanced practice registered nurse, and that same practitioner must determine that you are incapacitated. A directive locked in a safe deposit box is not operative no matter how carefully it was signed. Connecticut does not require the incapacity finding to be written down first, though the practitioner must disclose it in writing whenever your named representative asks.

How do I revoke a Connecticut living will or a health care representative appointment?

The two rules differ, and people miss it. Under § 19a-579a(a) you may revoke a living will at any time and in any manner, without regard to your mental or physical condition. Under § 19a-575a(b) an appointment of a health care representative may only be revoked by you, in writing, and that writing must be signed by you and two witnesses. Section 19a-579b separately revokes a spouse's appointment on divorce, legal separation, annulment or dissolution unless you specified otherwise, and § 19a-575a(e) confirms that revoking the appointment does not by itself revoke your living will.

Is a Connecticut living will suspended while I am pregnant?

No. Connecticut repealed its pregnancy exclusion. Section 19a-574 was repealed effective May 24, 2018 by Public Act 18-11. The same act put a three-option election inside both statutory forms: accept life support systems if the doctor believes doing so would let the fetus reach a live birth, apply the document without modifications, or write your own instructions. The choice belongs to you rather than to the statute, so check that any form you sign carries the election.

This page is general information about incapacity planning in Connecticut, and Conn. Gen. Stat. chapter 368w controls. The Attorney General's circulated forms are older than the current statutory text and carry neither the pregnancy election nor the advanced practice registered nurse references, so compare any downloaded PDF against the sections above. Confirm anything affecting your own care with a licensed Connecticut attorney or your own physician before you sign.

Sources:

• Title: Conn. Gen. Stat. § 19a-570, Definitions. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-570
• Title: Conn. Gen. Stat. § 19a-571, Liability re removal of life support system of incapacitated patient. Consideration of wishes of patient. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-571
• Title: Conn. Gen. Stat. § 19a-572, Failure to execute document creates no presumption re wishes of patient. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-572
• Title: Conn. Gen. Stat. § 19a-573, Comfort care and pain alleviation to be provided. Documents executed prior to October 1, 1991. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-573
• Title: Conn. Gen. Stat. § 19a-574, Nonapplicability to pregnant patient (repealed effective May 24, 2018 by P.A. 18-11, S. 4). Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-574
• Title: Conn. Gen. Stat. § 19a-575, Form of document re health care instructions and withdrawal or withholding of life support systems. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-575
• Title: Conn. Gen. Stat. § 19a-575a, Form of document re health care instructions, appointment of health care representative, designation of conservator for future incapacity and anatomical gift. Revocation of appointment. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-575a
• Title: Conn. Gen. Stat. § 19a-576, Appointment of health care representative. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-576
• Title: Conn. Gen. Stat. § 19a-577, Form of document re appointment of health care representative. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-577
• Title: Conn. Gen. Stat. § 19a-578, Proof of living will document or document appointing health care representative. Physician to make documents and oral communications part of medical record. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-578
• Title: Conn. Gen. Stat. § 19a-579, When living will or appointment of health care representative becomes operative. Disclosure of physician's determination of incapacity. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-579
• Title: Conn. Gen. Stat. § 19a-579a, Revocation of living will. Absence of knowledge of revocation. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-579a
• Title: Conn. Gen. Stat. § 19a-579b, Revocation of appointment of spouse as health care representative upon divorce or legal separation. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-579b
• Title: Conn. Gen. Stat. § 19a-580, Notification of certain persons prior to removal of life support system. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580
• Title: Conn. Gen. Stat. § 19a-580a, Transfer of patient when attending physician or health care provider unwilling to comply with wishes of patient. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580a
• Title: Conn. Gen. Stat. § 19a-580b, Prohibition re requiring living will or appointment of health care representative as condition of treatment or health benefits. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580b
• Title: Conn. Gen. Stat. § 19a-580c, Probate Court jurisdiction over disputes and capacity of health care representative. Health care representative's standing to challenge revocation. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580c
• Title: Conn. Gen. Stat. § 19a-580d, Do not resuscitate orders. Definition. Regulations. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580d
• Title: Conn. Gen. Stat. § 19a-580e, Conservator's duty to comply with conserved person's health care instructions or other wishes. Precedence of health care representative's decisions. Exceptions. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580e
• Title: Conn. Gen. Stat. § 19a-580f, Validity of advance directives, appointments of health care agent and powers of attorney for health care decisions executed before October 1, 2006. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580f
• Title: Conn. Gen. Stat. § 19a-580g, Validity of advance directives executed in other states or foreign countries. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580g
• Title: Conn. Gen. Stat. § 19a-580h, Medical orders for life-sustaining treatment program. Regulations. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_368w.htm#sec_19a-580h
• Title: Conn. Gen. Stat. § 1-56r, Designation of person for decision-making and certain rights and obligations. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_007c.htm#sec_1-56r
• Title: Conn. Gen. Stat. § 17a-540, Definitions (psychosurgery and shock therapy). Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_319i.htm#sec_17a-540
• Title: Conn. Gen. Stat. § 45a-656, Duties of conservator of the person. Determinations re breach of fiduciary duty. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_802h.htm#sec_45a-656
• Title: Conn. Gen. Stat. § 45a-2, Probate districts. Publisher: Connecticut General Assembly. Publication Date: Not listed. URL: https://www.cga.ct.gov/current/pub/chap_801.htm#sec_45a-2
• Title: Connecticut's Living Will Laws. Publisher: Connecticut Office of the Attorney General. Publication Date: Not listed. URL: https://portal.ct.gov/ag/health-issues/connecticuts-living-will-laws
• Title: Medical Orders for Life Sustaining Treatment MOLST. Publisher: Connecticut Department of Public Health. Publication Date: Not listed. URL: https://portal.ct.gov/dph/medical-orders-for-life-sustaining-treatment-molst

It is not legal advice.