Iowa Code ch. 144A · ch. 144B · Iowa
Iowa: how to sign your advance directive
Iowa keeps its two instruments in two chapters, and neither chapter pretends to cover the other's ground. The declaration is ch. 144A, the Life-sustaining Procedures Act — a document directing the withholding or withdrawal of life-sustaining procedures. The durable power of attorney for health care is ch. 144B, a separate instrument with its own execution rule, its own witness disqualifications and its own eligibility bar on who may be the attorney in fact. Chapter 144A's own table of contents points at the other one: "See also chapter 144B concerning durable power of attorney for health care."
Why WearableDocs
In Iowa, 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 Iowa asks
What you need to sign in Iowa
- Instruments
- Two, in separate chapters — a declaration (ch. 144A, the "Life-sustaining Procedures Act") · a durable power of attorney for health care (ch. 144B)
- Form
- Illustrative in both — the declaration "may, but need not, be in the following form" (§144A.3(5)); the durable power of attorney "may, but need not, be in the following form" (§144B.5(1))
- Execution
- Two witnesses OR a notary — and the notary must be in Iowa. Both instruments must contain their date of execution; each is valid if signed by two individuals who witnessed the signing in the presence of each other and the principal, or "acknowledged before a notarial officer within this state as provided in chapter 9B" (§144A.3(2), §144B.3(1))
- May not witness
- Declaration: a health care provider attending the declarant on the date of execution; an employee of such a provider; anyone under 18 (§144A.3(2)(a)–(b)). Durable power of attorney: the same three, plus the individual designated as attorney in fact (§144B.3(2)). In both, at least one witness must not be a relative of the declarant or principal by blood, marriage or adoption within the third degree of consanguinity (§144A.3(2), §144B.3(3))
- May not be your agent
- A health care provider attending the principal on the date of execution, and an employee of such a provider — unless the person designated is related to the principal by blood, marriage or adoption within the third degree of consanguinity (§144B.4)
- Copy rule
- None found in either chapter
- Delivery
- No delivery precondition. §144A.3(3) makes notification the declarant's responsibility and adds that a provider "may presume, in the absence of actual notice to the contrary, that the declaration complies with this chapter and is valid". Revocation of a durable power of attorney follows the same shape: §144B.8(4) makes notifying the provider the principal's responsibility, and a provider who is notified "shall document the revocation in the treatment records of the principal"
- Registry
- None found in either chapter
- Age
- 18 — §144A.2(1): "Adult" means an individual eighteen years of age or older. No departure recorded
- Reciprocity
- Yes, in both chapters. A declaration or durable power of attorney "executed in another state or jurisdiction in compliance with the law of that state or jurisdiction shall be deemed valid and enforceable in this state, to the extent" it is consistent with Iowa law (§144A.3(4), §144B.3(4)). A directive executed by a veteran under federal Department of Veterans Affairs requirements "shall be deemed valid and enforceable"
- Pregnancy
- Yes, and it switches the declaration off. §144A.6(2): "The declaration of a qualified patient known to the attending physician to be pregnant shall not be in effect as long as the fetus could develop to the point of live birth with continued application of life-sustaining procedures." No equivalent provision appears in ch. 144B
- Revocation
- Divorce revokes a spouse-agent designation. §144B.8(3): if the marriage between the principal and the attorney in fact is dissolved "the power is thereby revoked", and "in the event of remarriage to each other, the power is reinstated unless otherwise revoked by the principal." A valid durable power of attorney also revokes any prior one (§144B.8(3)); the principal is presumed to have capacity to revoke (§144B.8(2))
- Oral instructions
- Neither instrument may be executed orally. Revocation may be oral: a declaration "may be revoked at any time and in any manner by which the declarant is able to communicate the declarant's intent to revoke, without regard to mental or physical condition" (§144A.4(1)), and a durable power of attorney may be revoked by notifying the attorney in fact "orally or in writing" (§144B.8(1))
- Carried device
- Nothing for the directive. See below
- Citation
- Iowa Code ch. 144A · ch. 144B
Read from the enacted statute, 2026-09-18.
The instrument
What Iowa actually recognizes
Both instruments are executed the same way, and the shared rule has a condition attached that is easy to miss: two witnesses or a notary, and if you use a notary, the notary must be a notarial officer within this state (§144A.3(2)(b), §144B.3(1)(b), both under ch. 9B). A directive acknowledged before an out-of-state notary is not executed by either route.
The two chapters also diverge in two smaller ways worth noting. Chapter 144B lists the attorney in fact among the people who may not witness; ch. 144A's declaration list does not. And ch. 144B says in terms who may not be the attorney in fact, which ch. 144A never does for a declaration.
Carried on you
What a WearableDocs card does in Iowa
WearableDocs is how your Iowa advance directive gets found. Neither chapter contains a bracelet, necklace, card or identification provision, and neither creates a registry. Chapter 144A.7A does create an out-of-hospital do-not-resuscitate order — a written order signed by a physician — but it is a separate instrument, and the captured chapter attaches no device to it.
What Iowa has instead is a pair of notification duties that put the document's movement in the signer's hands. The declaration: "It is the responsibility of the declarant to provide the declarant's attending physician or health care provider with the declaration" (§144A.3(3)), with a safe harbour for the provider who acts in the absence of actual notice to the contrary. The durable power of attorney: §144B.8(4) makes notification the principal's responsibility too, and requires a provider who receives a revocation to document it in the treatment records.
That is the findability case stated by the statute rather than implied by it. The document does not have to reach anyone before it is valid — but in Iowa, the declarant is the one the statute expects to move it. And once, plainly: an advance directive does not bind EMS on CPR. The out-of-hospital DNR order is the instrument that does, and it needs a physician's signature.