An Oregon advance directive is a written document in which a capable adult names a health care representative and records treatment preferences for a time when they can no longer speak for themselves. To be legally effective in Oregon, you must sign the document and either have two adult witnesses sign it or have it notarized.1Oregon State Legislature. Oregon Code 127.515 – Execution; Witnesses; Out-of-State Execution The rules changed meaningfully in 2021 under Senate Bill 199, so forms and guides published before then may describe requirements that no longer apply.
Who Can Create One
You have to meet two conditions. First, you must be an “adult” under ORS 127.505, meaning you are 18 or older, an emancipated minor, or a minor who is married. Second, you must be “capable” when you sign, which under Oregon law means you can make health care decisions and communicate them to a provider, either directly or through someone familiar with how you communicate.2Oregon State Legislature. Oregon Revised Statutes Chapter 127 – Powers of Attorney; Advance Directives for Health Care Don’t wait until a diagnosis puts your capacity in question.
What the Form Covers
Oregon’s statutory advance directive follows the format set out in ORS 127.529. The Oregon Health Authority publishes the form on its website, and most health care providers can give you a copy.3Oregon Health Authority. Advance Directive Forms You do not have to use the state’s exact form, but whatever you use must be “substantially” similar to the statutory version.4Oregon State Legislature. Oregon Revised Statutes Chapter 127 – Powers of Attorney; Advance Directives for Health Care – Section 127.529
Naming a Health Care Representative
The first main section asks you to name a health care representative and up to two alternates, along with their contact information. If your primary representative is out of reach during an emergency, the alternate steps in without any court involvement. That is the whole point of naming backups.
Treatment Preferences
Under ORS 127.533, the form must at minimum address your preferences on life support, tube feeding, and placement in a care home or mental health facility.5Oregon State Legislature. Oregon Revised Statutes Chapter 127 – Powers of Attorney; Advance Directives for Health Care – Section 127.533 “Life support” means any medical treatment that keeps you alive by sustaining, restoring, or replacing a vital function. “Tube feeding” means artificially administered food and water.
The form typically walks you through scenarios such as a terminal condition, permanent unconsciousness, or advanced dementia, and asks whether you want full treatment, limited intervention, or comfort care only in each situation. You can also attach supplemental pages with additional instructions or personal and spiritual directions, and those attachments become part of the directive. The more concrete your directions, the less your representative has to guess.
Choosing and Briefing Your Representative
Your representative’s authority is broad but not unlimited. Oregon law flatly prohibits a health care representative from consenting on your behalf to convulsive treatment, psychosurgery, sterilization, or abortion.6OregonLaws. Oregon Revised Statutes 127.540 – Limitations on Authority of Health Care Representative Those decisions remain yours alone.
Withdrawing life-sustaining treatment carries extra safeguards. Your representative cannot authorize stopping life support unless you explicitly gave them that authority in the directive, or your condition has been medically confirmed as terminal, permanently unconscious, causing permanent severe pain from continued treatment, or an advanced fatal illness where you can no longer communicate, swallow safely, care for yourself, or recognize family.6OregonLaws. Oregon Revised Statutes 127.540 – Limitations on Authority of Health Care Representative
Tube feeding works differently. Oregon law presumes that every incapacitated person has consented to artificially administered nutrition and hydration unless specific exceptions apply, such as a clear statement you made while capable that you would refuse it, or an express grant of authority to your representative over that decision.7Oregon State Legislature. Oregon Code 127.580 – Presumption of Consent to Artificially Administered Nutrition and Hydration If you feel strongly about tube feeding either way, address it directly in the directive.
One detail people skip: the appointment is not legally effective until the representative accepts. Acceptance can happen by signing the acceptance section of the form or by verbally telling someone.8OregonLaws. Oregon Revised Statutes 127.527 – Form for Appointing Health Care Representative A signed acceptance is far better because it removes any dispute later. Have a real conversation with the person first. They need to understand your values and be willing to carry out decisions that may be hard.
Signing Requirements
This is where directives live or die. An unsigned or improperly witnessed document has no legal force. You sign the directive, then complete one of two validation steps:
- Two adult witnesses, both of whom watch you sign (or hear you acknowledge your signature) and then sign the form themselves.
- Notarization by a notary public.
One method is enough. You don’t need both.1Oregon State Legislature. Oregon Code 127.515 – Execution; Witnesses; Out-of-State Execution
Who Can Witness
Witness rules were streamlined by SB 199 in 2021 and are now simpler than many published guides suggest. Neither witness can be your attending physician or health care provider, and neither can be a health care representative or alternate you named in the directive.1Oregon State Legislature. Oregon Code 127.515 – Execution; Witnesses; Out-of-State Execution Older Oregon forms and some online resources still list restrictions on relatives, estate beneficiaries, and facility employees. Those requirements were part of the pre-2021 law and no longer appear in the current statute. A family member who is not your representative or your doctor can witness under current law.
If you use a notary instead of witnesses, Oregon caps the fee at $10 per notarial act for in-person notarization and $25 for remote notarization.9OregonLaws. Oregon Revised Statutes 194.400 – Fees for Notarial Acts; Collection of Fees Many banks, credit unions, and shipping stores offer notary services, and some do it free for account holders.
Changing or Revoking a Directive
You can revoke your advance directive at any time and in any manner, as long as you are capable. For decisions specifically about life support or tube feeding, the standard is lower: you can revoke by any means through which you communicate your intent, even if you are no longer considered fully capable.10Oregon State Legislature. Oregon Code 127.545 – Revocation of Advance Directive or Health Care Decision The revocation takes effect once you communicate it to your attending physician, health care provider, or health care representative, and the provider must record it in your medical chart.
Signing a new directive automatically revokes any prior one, unless the new document says otherwise.10Oregon State Legislature. Oregon Code 127.545 – Revocation of Advance Directive or Health Care Decision Any reinstatement of a previously revoked directive must be in writing. Oregon doesn’t have a formal amendment process, so if you want to change something, execute a new directive and pull the old copies out of circulation.
Divorce Suspends a Spousal Appointment
If you named your spouse as your health care representative and either of you files for divorce or annulment, the appointment is automatically suspended. It stays suspended unless you reaffirm the appointment in writing after the petition is filed.10Oregon State Legislature. Oregon Code 127.545 – Revocation of Advance Directive or Health Care Decision Long separations catch a lot of people this way. If you’re in a divorce, updating the directive belongs near the top of the list.
Advance Directive vs. POLST
An advance directive is not the same thing as a POLST (Physician Orders for Life-Sustaining Treatment), and the two often get confused. An advance directive is a legal document any capable adult can create; it names a representative and records general treatment preferences. A POLST is a medical order signed by a physician, nurse practitioner, or physician assistant that translates those preferences into clinical instructions emergency responders and hospital staff can follow immediately. Oregon maintains an electronic POLST Registry so providers can access the orders statewide.
The advance directive is designed for everyone over 18. The POLST is intended for people with serious illness or who are very old and frail. Most adults should start with an advance directive and add a POLST only if their health situation calls for it.
What Happens If You Never Sign One
If you become unable to make medical decisions and never appointed a representative, ORS 127.635 sets a default priority list of who steps in, in this order: a court-appointed guardian with health care authority, your spouse, an adult chosen by the others on this list, a majority of your adult children, either parent, a majority of your adult siblings, and any adult friend. If nobody on that list is available, your attending physician or health care provider can make decisions for you.2Oregon State Legislature. Oregon Revised Statutes Chapter 127 – Powers of Attorney; Advance Directives for Health Care That default frequently produces disputes, especially in blended families or when adult siblings disagree. A directive replaces the list with a single person you chose.
Where to Keep It and Who Should Have a Copy
A signed directive nobody can find during an emergency is useless. Once yours is complete, give copies to your health care representative and any alternates so they can produce it for medical staff. Give a copy to your primary care physician for your permanent medical record. Keep the original somewhere accessible at home rather than in a safe deposit box or anywhere that requires a key or combination during a crisis.
If you receive regular care at a specific hospital or clinic, dropping off a copy lets staff pull up your directive on admission even before your representative arrives. Some Oregon residents also upload their directive to electronic registries or patient portals for around-the-clock access. If you travel frequently, carry a wallet card with your representative’s contact information and the location of the directive. All 50 states generally recognize advance directives, but specific treatment choices documented on an Oregon form may not perfectly align with another state’s law, so if you spend significant time in another state and have serious health conditions, consider completing a directive under that state’s law as well.
Review your directive every few years and after any major life change: a new diagnosis, a marriage, a divorce, the death of your representative. When you sign a new version, retrieve and destroy the old copies so conflicting documents don’t circulate.