Updated August 3, 2026. Quick answer: Iowa calls this instrument declaration relating to use of life-sustaining procedures (living will), durable power of attorney for health care. To execute it you need 2 witnesses — and the state requires witnesses OR a notary — either one. Getting that conjunction wrong is the most common way a directive fails when it is needed.
The execution box
| What the state calls it | declaration relating to use of life-sustaining procedures (living will), durable power of attorney for health care |
|---|---|
| Witnesses required | 2 |
| Witnesses or notary? | witnesses OR a notary — either one |
| Who may NOT witness | A witness may not be a health care provider attending the declarant on the date of execution, or an employee of such a health care provider, and may not be under eighteen years of age. At least one of the two witnesses must not be a relative of the declarant by blood, marriage, or adoption within the third degree of consanguinity. |
| If you are in a care facility | No special rule found in the text we read |
| Authority | Iowa Code § 144A.3 |
What the statute says
at least two individuals who, in the presence of each other and the declarant, witnessed the signing … [or] acknowledged before a notarial officer within this state as provided in chapter 9B
— Iowa Code § 144A.3
The form
We did not find an official state form. That does not mean none exists. A directive does not require a state form to be valid, provided it is executed as the statute requires.
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
Verified on official legis.iowa.gov (RTF-format statute text, chapter 144A covers the living will; chapter 144B, the separate durable power of attorney for health care, was not independently reviewed for its own execution requirements).
Related: all states compared · living will versus healthcare proxy · what it costs.
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.