D.C. Code Title 21, ch. 22 — Health-Care Decisions · District of Columbia
District of Columbia: how to sign your advance directive
The District has no instrument called a living will. Chapter 22 of Title 21 is built as subchapters, and the first — Durable Power of Attorney, §§21-2201 to 21-2213 — is the directive. The person named in it is not called an agent: the chapter's term is the attorney in fact (§21-2202(1)), and the sample form uses that phrase throughout.
Why WearableDocs
In District of Columbia, the directive has to be found
It does not wait on delivery to a clinician to operate — but a document no one can produce when asked for is a document that fails in practice. WearableDocs puts the signed directive on a card you carry and a page that opens in seconds, instead of a phone call to whoever might know which drawer.
You answer a few questions — your name, your state, and what you refuse — and WearableDocs builds the directive. Print it, sign it, upload it. Changing your answers later is part of the plan, so nothing is locked in.
What District of Columbia asks
What you need to sign in District of Columbia
- Instruments
- Two, in separate subchapters — a durable power of attorney for health care (the holder is the "attorney in fact") · a MOST Form
- Form
- Illustrative — §21-2207: "offered as a sample form only and its inclusion in this section shall not be construed to preclude the use of alternative language"
- Execution
- Two witnesses, no notary — dated and signed by the principal and 2 adult witnesses who affirm sound mind and no duress (§21-2205(c))
- May not witness
- The principal; the principal's health-care provider; an employee of that provider (§21-2205(c)). At least one of the two must not be related to the principal by blood, marriage or adoption, and must not be entitled to any part of the estate by a current will or by operation of law (§21-2205(d))
- May not be your agent
- Limited. A provider is barred from being named attorney in fact only in the post-48-hour request context — after 48 hours in a facility a provider may request that a patient execute one, and "the health care provider may not be named as the attorney in fact" (§21-2209(b))
- Copy rule
- MOST only. "A copy of a MOST Form shall be as effective as an original" (§21-2221.04(d)). No copy-equivalence provision for the power of attorney
- Delivery
- No delivery precondition. A designated attorney in fact known to a provider to be available and willing "shall have priority over any other person to act for the principal" (§21-2206(b)(1))
- Who decides
- Two professionals, certified in the District: one physician and one qualified psychologist or psychiatrist. At least one of the two must examine the individual within 1 day preceding certification (§21-2204(a))
- Registry
- MOST only. §21-2221.14a directs DOH to contract for an electronic MOST service, approved by the MOST Advisory Committee and connected through the State-designated health information exchange. No registry for the power of attorney
- Age
- 18 — a "competent adult" may designate (§21-2205(a)); a patient 18 or older, or an authorized representative, executes a MOST (§21-2221.05(c)(1))
- Reciprocity
- In both subchapters. A document "validly executed in another jurisdiction pursuant to similar provisions of the law of that jurisdiction" counts as a durable power of attorney for health care (§21-2202(3)(A)); EMS personnel and other health care professionals "shall recognize a MOST Form or similar instrument executed in another state" (§21-2221.09)
- Revocation
- Divorce, annulment, or termination of a domestic partnership automatically revokes the former spouse's or partner's designation unless the document expressly provides otherwise, and the designation is revived by remarriage or by re-entry into the domestic partnership (§21-2208(e))
- Oral instructions
- The designation must be in writing (§21-2205(a)). Revocation may be oral — by notifying the attorney in fact orally or in writing (§21-2208(a)(1))
- Provider may not require
- §21-2209(a) — no provider "may require an individual to execute a durable power of attorney for health care as a condition for the provision of health-care services or admission to a health-care facility". §21-2221.05(a): "no patient shall be required to complete or execute a MOST Form". §21-2221.13(c): a MOST cannot be a condition of insurance, health care services, or employment benefits
- Carried device
- The MOST, not the power of attorney — possession creates a duty, and doubt resolves to resuscitation
- Citation
- D.C. Code Title 21, ch. 22 — Health-Care Decisions
Read from the enacted statute, 2026-09-18.
The instrument
What District of Columbia actually recognizes
Subchapter II is a different instrument doing a different job — the MOST Form, §§21-2221.01 to 21-2221.15, a set of portable medical orders completed by a health care professional and signed by the patient or the patient's authorized representative. It is not a substitute for the power of attorney, and the chapter says which one wins when they conflict: "the most recent document to have been executed shall govern" (§21-2221.10).
The power of attorney subchapter is the older of the two and is precise about its own terms. §21-2202(3)(B) makes the instrument "effective upon, and only during incapacitation," and §21-2205(b) requires the writing to carry one of two sentences making that durability explicit — "This power of attorney shall not be affected by the subsequent incapacity of the principal" or "This power of attorney becomes effective upon the incapacity of the principal."
Carried on you
What a WearableDocs card does in District of Columbia
WearableDocs is how your District of Columbia advance directive gets found. The District gives a carried document real force, and the document is the MOST Form, not the power of attorney.
§21-2221.07(a) opens with possession:
"If an EMS personnel or health care professional encounters a person who is in possession of a MOST Form, the EMS personnel or health care professional shall determine whether the person is the subject of the MOST Form and whether the MOST Form has been revoked."
That is a duty triggered by the object being on the person. The same section then bounds it twice, and both bounds matter.
- (a)(2): "If there is uncertainty as to whether the MOST Form has been revoked, the EMS personnel or health care professional shall act as if there were no MOST Form and resuscitate the patient."
- (b): if the MOST Form "is unreadable", EMS "shall proceed as if there were no MOST Form."
So the District's rule is possession, with doubt resolving to treatment. A MOST that has been revoked, or that cannot be read, is not merely unhelpful — it is treated as absent. Where EMS does withhold resuscitation on the strength of a MOST, §21-2221.07(c) requires the do-not-resuscitate response to be recorded in the run report and reported to DOH within 5 business days.
None of that reaches the durable power of attorney. A District power of attorney carried on the person has no device provision, no bracelet, necklace or card statute, and no copy-equivalence rule. What it has is the findability problem the sample form addresses in plain capitals:
"GIVE A COPY TO THE PERSON YOU NAME AS YOUR ATTORNEY IN FACT. IF YOU ARE IN A HEALTH-CARE FACILITY, A COPY OF THIS DOCUMENT SHOULD BE INCLUDED IN YOUR MEDICAL RECORD." (§21-2207)
And once, plainly: an advance directive does not bind EMS on CPR. The MOST is the instrument that speaks to that, and the chapter keeps the two apart.