The South Dakota advance directive form is a two-part document that lets you name a healthcare agent to make medical decisions when you cannot and lets you write down which life-sustaining treatments you want or refuse if you reach a terminal condition or permanent unconsciousness. Part I is a durable power of attorney for healthcare under SDCL 59-7-2.1. Part II is a living will declaration under SDCL Chapter 34-12D. You can complete both on the same form, or fill out just one.1South Dakota Legislature. South Dakota Codified Law 59-7-2.1
Where To Find the Form
A downloadable version that tracks South Dakota’s statutory requirements is available through CaringInfo, a program of the National Hospice and Palliative Care Organization.2CaringInfo. South Dakota Advance Directive Forms Some South Dakota hospitals distribute their own versions that comply with state law. The South Dakota Department of Health page on advance directives exists, but it points mainly to MOST (Medical Orders for Scope of Treatment) and Comfort One forms rather than a general advance directive template.3South Dakota Department of Health. Advance Directives and Medical Orders Whichever version you use, the content and execution rules come from SDCL 59-7-2.1 and Chapter 34-12D.
Naming Your Healthcare Agent
Part I appoints an agent (sometimes called an attorney-in-fact) who can make healthcare decisions any time you lack capacity. Under SDCL 59-7-2.1, that authority is broad: your agent can consent to, refuse, or withdraw consent for any care, service, or procedure used to maintain, diagnose, or treat a physical or mental condition. Surgery, medication, hospital transfers, and discharge all fall within that scope.
Write in your agent’s full legal name, current address, and phone number. Name at least one alternate agent too. If your first choice is traveling, ill, or unreachable, the alternate steps in without a gap in authority. Two alternates is better than one.
Tube Feeding and IV Hydration Require Explicit Authority
Here is the detail people miss: your agent does not automatically have power to withhold or withdraw artificial nutrition and hydration. If you want your agent to be able to make that call, the form must say so explicitly. This is a deliberate safeguard in South Dakota law, and skipping the box or clause leaves your agent unable to act on one of the most consequential end-of-life decisions.
Writing Your Living Will Instructions
Part II speaks directly to healthcare providers about what you want done when you reach a terminal condition or permanent unconsciousness. South Dakota defines a terminal condition as an incurable and irreversible condition where, under accepted medical standards, death is imminent without life-sustaining treatment. The definition also covers permanent unconsciousness, a coma or similar state expected to last indefinitely in which you cannot communicate or interact purposefully.4South Dakota Legislature. South Dakota Codified Law 34-12D-1(7) Either situation triggers the instructions you write.
The declaration must address artificial nutrition and hydration, meaning food and water delivered through a tube into the stomach, intestine, or a vein.5South Dakota Legislature. South Dakota Codified Law 34-12D-3 The standard form gives you two options to initial, and you pick only one:
- Decline artificial nutrition and hydration. If death is imminent or you are permanently unconscious, you do not want tube feeding or IV hydration, and if it has already started, you want it stopped.
- Continue artificial nutrition and hydration. Even if death is imminent or you are permanently unconscious, you want feeding and hydration to continue.
The form also has space to address other life-sustaining treatment: ventilators, cardiopulmonary resuscitation, and comfort care preferences. Write concretely. Vague language like “no heroic measures” invites disagreement about what counts as heroic. Specific instructions remove that ambiguity.
Pregnancy Limits What the Directive Can Do
South Dakota law requires that life-sustaining treatment and artificial nutrition and hydration be provided to a pregnant patient regardless of what the directive says, unless the treatment will not maintain fetal development to the point of live birth, would be physically harmful to the pregnant person, or would prolong severe pain that cannot be managed.6South Dakota Legislature. South Dakota Codified Law 34-12D-10 Your agent and your physicians must follow that rule even if the directive says otherwise.
Signing and Witnessing
Both parts need a formal signing, and the requirements are similar but sit in different statutes.
For Part I, the durable power of attorney for healthcare must be signed by you, or by someone else in your conscious presence at your direction, and witnessed by two adults or by a notary public. You do not need both; either satisfies SDCL 59-7-2.1.
For Part II, the living will declaration must also be signed by you (or by another person at your direction) and witnessed by two adults or notarized by a notary public.7South Dakota Legislature. South Dakota Codified Law 34-12D-2 Again, two witnesses or a notary. You choose one path.
Who Should Not Be a Witness
South Dakota’s statutes do not list categories of people disqualified from witnessing an advance directive; they require only that witnesses be adults. Even so, pick witnesses who have no financial stake in your estate and no role in your medical care. That is common-sense protection if anyone later challenges the document. Your named healthcare agent is a poor witness choice for the same reason: the person whose authority the document creates should not also be vouching for its validity. Two neighbors, coworkers, or friends with no connection to your healthcare or finances work well.
Distributing and Storing the Signed Form
A properly executed directive is useless if no one can find it during an emergency. Once it is signed, give copies to:
- Your healthcare agent and any alternate. They need it to prove their authority when talking to medical staff.
- Your primary care physician. Ask the office to scan it into your medical record.
- Any hospital or clinic where you receive regular care. Separate health systems do not always share records, so file a copy at each.
- Close family members. Even if they are not your agent, they should know the directive exists and where to find it.
Keep the original somewhere secure but accessible, such as a fireproof home safe or a clearly labeled folder. A bank safe deposit box can be hard to reach in a medical emergency if no one else has a key. Some people carry a wallet card noting that an advance directive exists and listing where copies are filed.
Changing or Revoking the Directive
You can revoke a living will declaration at any time. No particular procedure is required. You can destroy the document, write a signed statement of revocation, or tell your healthcare provider orally that you revoke it. When you revoke or update the directive, notify everyone who received a copy so old versions do not stay in circulation. If you create a new advance directive, state in it that all prior directives are revoked, and get the replacement to any hospital or physician who still has the old one on file.
A new diagnosis, a marriage or divorce, or the death of your named agent are natural moments to revisit the document. Even without a triggering event, reviewing the directive every few years keeps your instructions in step with your current values and medical situation.