Vermont Advance Directives
The legal tool for documenting your health care preferences
Definition: An advance directive is a legal document used to appoint a medical decision-maker (health care agent) and record your preferences for medical treatments and interventions. Living Wills, Durable Powers of Attorney for Health Care, Health Care Proxy documents and Treatment Directives are all types of advance directives.
Completing the Advance Directive Form
Vermont does not have a specific form that must be used for advance directives, so you can choose the form that works best for you. All advance directive forms from the Vermont Ethics Network have space for the appointment of a health care agent and a description of your treatment preferences.
Browse Forms | Choosing Which Form is Right for You
For your directive to be a legal document, it must be signed by you (the principal) and two witnesses. Witnesses CANNOT be your health care agents, spouse, parents, siblings, children, or grandchildren.
When your advance directive has been signed and witnessed, it is a legal advance directive.
Once completed:
- Make Copies! Give copies to your agent, your health care provider, your local hospital, and any friends/family you wish.
- Keep the original document in a safe place for yourself. You may also wish to keep a copy in an easily accessible place in your home in case of emergency.
- Register a copy of your document with the Vermont Advance Directive Registry (VADR) where it can be accessed by your health care team when needed. Advance directive forms from the Vermont Ethics Network include the VADR Administrative form to register your document. The VADR is a free service for all Vermont residents and is highly recommended, but not required. Your advance directive is valid even if it has not been registered.
- Vermont Advance Directive Checklist
Who needs an advance directive?
Everyone over the age of 18 who can make their own medical decisions should have an advance directive. These documents are not just for people with terminal illnesses. Whether you’re 18 or 81, sudden accident or illness can happen at any time. Clinicians may need your health care agent to make decisions and give consent for treatments even if you are likely to recover. At minimum, everyone who can make their own medical decisions should appoint a health care agent.
After you have had advanced care planning conversations with your loved ones and your health care providers, complete an advance directive to record the decisions that you made.
Persons under medical guardianship cannot complete advance directives because they have been deemed legally incompetent to make medical decisions for themselves. If you are the medical guardian for someone and are asked to produce an advance directive, you should provide a copy of the guardianship order instead.
When and how are advance directives used?
Your advance directive takes effect when you lack the capacity to make a medical decision. Capacity, or lack of capacity, is determined by a clinician. If you are unable to understand the treatment options, or are unconscious and unable to communicate, your health care team will turn to your appointed health care agent to make decisions about your treatment. They will also follow the statements you have made in your advance directive to determine which treatment options would be most effective and appropriate for you.
Where do I start?
In Vermont, there is not a specified advance directive form that you must use. Any document that speaks to your health care preferences and is properly signed and witnessed is an advance directive. The form that you choose will depend on what kind of information you want to document in your advance directive.
Our Taking Steps Program offers a stepwise approach to using the available tools for documenting your advance care plan. You can browse the advance directive forms produced by the Vermont Ethics Network here.
What is the difference between an advance directive and a DNR/COLST order?
An advance directive is a legal document completed by an individual who is capable of making their own decisions. These are preference-based documents that guide care and treatment in the future if the individual is not able to speak for themselves. In your advance directive, you can appoint a healthcare agent to speak for you and describe your treatment preferences. Nobody else can complete an advance directive for you. Advance directives are not actionable for emergency first responders.
A DNR/COLST order is a medical order created through a shared decision-making process between a clinician (MD, DO, APRN, PA) and a patient. Consent for a DNR/COLST can be provided by someone other than the patient if the patient lacks capacity. These documents require informed consent, will guide the current treatment plan, and are legally recognized by all medical providers, including emergency first responders.
More Advance Directive Facts
- In Vermont, there is no default surrogate statute. This means that it is not automatically a person’s next of kin (spouse, parents, adult siblings, etc.) who will make medical decisions if a person is unable to speak for themselves.
- A lawyer is not required for creating or revising advance directives. In Vermont, these documents only need be witnessed by two adults and do not have to be notarized.
- For advance directives to be effective, people need to have conversations with their appointed decision-maker and other loved ones about their values and what matters most to them. Speak with those close to you about what you want to say in your advance directive so that they can understand your thought process and values.
