Updated September 3, 2026. Quick answer: Hawaii calls this instrument Advance health-care directive (individual instruction and/or power of attorney for health care) under the Uniform Health-Care Decisions Act. Witnesses needed to execute it: 2 (for the power-of-attorney-for-health-care component). What the state requires: Either: signed by 2 witnesses who witnessed the signing/acknowledgment, OR acknowledged before a notary anywhere in Hawaii: notarization fully substitutes for witnesses.. Getting the execution formalities wrong is the most common way a directive fails when it is needed.
The execution box
| What the state calls it | Advance health-care directive (individual instruction and/or power of attorney for health care) under the Uniform Health-Care Decisions Act |
|---|---|
| Witnesses required | 2 (for the power-of-attorney-for-health-care component) |
| Witnesses or notary? | Either: signed by 2 witnesses who witnessed the signing/acknowledgment, OR acknowledged before a notary anywhere in Hawaii: notarization fully substitutes for witnesses. |
| Who may NOT witness | A health-care provider; an employee of a health-care provider or facility; or the named agent. At least one of the two witnesses must also not be related to the principal by blood, marriage, or adoption, nor entitled to any portion of the principal’s estate. |
| If you are in a care facility | None: HRS Chapter 327E contains no special patient-advocate/ombudsman witness requirement for principals in a hospital or care facility at signing (a rule present in some other UHCDA states, e.g. California, but not in Hawaii). |
| Authority | Haw. Rev. Stat. § 327E-3(b)-(d); optional statutory form at § 327E-16 |
What the statute says
“The power shall be in writing, contain the date of its execution, be signed by the principal, and be witnessed by one of the following methods: (1) Signed by at least two individuals, each of whom witnessed either the signing of the instrument by the principal or the principal’s acknowledgment of the signature of the instrument; or (2) Acknowledged before a notary public at any place within this State.” (HRS § 327E-3(b))
(Haw. Rev. Stat. § 327E-3(b)-(d); optional statutory form at § 327E-16)
The form
Yes: Hawaii publishes its own official statutory sample form directly inside the statute at HRS § 327E-16.
Why the witness rules matter more than the wording
People spend their effort on what the directive says and almost none on how it is signed. A directive that expresses your wishes perfectly but was witnessed by someone the statute disqualifies may not be honoured. The disqualification lists exist because the people most likely to be in the room, family, the treating doctor, facility staff, are the people with an interest in the outcome.
Two practical consequences. Ask who is signing before the appointment, not during it. And if you are already in a hospital or care facility, check the facility rule row above: several states add a requirement that applies only to patients and residents, and it is the one nobody mentions.
This is the medical instrument, not the financial one
A financial power of attorney is a different document with different execution rules. Having one does not give anyone authority over your medical care, and having this one gives nobody authority over your money. Most people need both, and they are executed separately.
What could not be verified
Fully verified: full chapter text fetched and read directly from the official Hawaii State Legislature site (data.capitol.hawaii.gov PDF of HRS Chapter 327E): treated as primary. Caution: an initial draft summary fabricated a nonexistent ‘ombudsman witness’ rule and mis-cited §327E-5; this was caught and corrected against the raw fetched PDF text: no such rule exists in HRS 327E.
Related: all states compared · living will versus healthcare proxy · what it costs.
Also for Hawaii: Hawaii Small Estate Affidavit · Hawaii Power of Attorney Requirements · What Adult Guardianship Costs in Hawaii.
General information drawn from state statutes and official state materials, not legal or medical advice. Advance-directive law is STATE law and the execution requirements differ in ways that decide whether a document works: some states require witnesses AND a notary, some accept either, and the list of people who may not witness varies. A directive executed the wrong way may not be honoured when it matters. Many states publish a free official form – you should not have to buy one.