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What this state guide covers
A quick view of the questions, practical details and source notes below.
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Updated August 3, 2026. Quick answer: Massachusetts calls this instrument health care proxy, health care agent. To execute it you need 2 witnesses — and the state requires Witnesses only — no notary path stated. Getting that conjunction wrong is the most common way a directive fails when it is needed.
The execution box
| What the state calls it | health care proxy, health care agent |
|---|---|
| Witnesses required | 2 |
| Witnesses or notary? | Witnesses only — no notary path stated |
| Who may NOT witness | No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy. |
| If you are in a care facility | A facility operator, administrator or employee cannot be named your agent if you are a patient or resident of that facility, or have applied to it, unless related to you by blood, marriage or adoption (section 3) |
| Authority | M.G.L. c.201D, §2 |
What the statute says
Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature.
— M.G.L. c.201D, §2
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.
Massachusetts health care proxy: what chapter 201D requires
Massachusetts calls the instrument a health care proxy. Each line below is a complete sentence quoted from General Laws chapter 201D, or a plain summary that says so.
- Signing and witnesses. “Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature.” (M.G.L. c. 201D, section 2) “The witnesses shall affirm in writing that the principal appeared to be at least eighteen years of age, of sound mind and under no constraint or undue influence.” (M.G.L. c. 201D, section 2)
- Who may not witness. “No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy.” (M.G.L. c. 201D, section 2)
- Who can sign, and who can be named. “Every competent adult shall have the right to appoint a health care agent by executing a health care proxy.” (M.G.L. c. 201D, section 2) Summarized, not quoted: section 3 bars an operator, administrator or employee of a facility from being named agent by a patient or resident of that facility, or by someone who has applied for admission, unless that person is related to the principal by blood, marriage or adoption.
- When it takes effect. “The authority of a health care agent shall begin after a determination is made, pursuant to the provisions of this section, that the principal lacks the capacity to make or to communicate health care decisions.” (M.G.L. c. 201D, section 6)
- What the agent can decide. “An agent shall have the authority to make any and all health care decisions on the principal’s behalf that the principal could make, including decisions about life-sustaining treatment, subject, however, to any express limitations in the health care proxy.” (M.G.L. c. 201D, section 5)
- How to revoke. “A principal may revoke a health care proxy by notifying the agent or a health care provider orally or in writing or by any other act evidencing a specific intent to revoke the proxy.” (M.G.L. c. 201D, section 7) “A health care proxy shall also be revoked upon: (i) execution by the principal of a subsequent health care proxy, or (ii) the divorce or legal separation of the principal and his spouse, where the spouse is the principal’s agent under a health care proxy.” (M.G.L. c. 201D, section 7)
Source: Massachusetts General Laws chapter 201D, health care proxies (malegislature.gov). These pages are general information; the section you rely on has exceptions.
A guided option for your health care proxy
Prefer guided questions? Choose Massachusetts in LawDepot and select the option to appoint someone to make health care decisions. Review the document options and pricing before continuing.
This optional builder prepares the document. You still need to follow the signing requirements above.
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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
We read sections 2, 3, 5, 6 and 7 of chapter 201D. Section 2, the execution section, contains no facility-specific witness rule; the facility restriction is in section 3 and concerns who may be named agent. We did not reproduce section 4 (contents of the proxy) or the sections on disputes and court proceedings.
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.