Maryland: how to sign your advance directive

What Maryland asks

What you need to sign in Maryland

Instruments

One combined advance directive. The agent appointment and the treatment preferences sit in the same document (§5-602(a)–(b)); the state's form calls Part II the "living will"

Form

Illustrative — §5-603: "Using this advance directive form to do health care planning is completely optional. Other forms are also valid in Maryland."

Execution

Two witnesses — never a notary. Dated, signed by you or at your express direction, and subscribed by two witnesses in your physical or electronic presence (§5-602(c)(1)(i))

May not witness

Your agent may not witness (§5-602(c)(2)(ii)). Otherwise any competent individual may — including an employee of a health care facility, or a nurse practitioner, physician assistant or physician caring for you, if acting in good faith. At least one of the two must not be knowingly entitled to any portion of your estate or to any financial benefit by reason of your death (§5-602(c)(2)(iii))

May not be your agent

A "disqualified person" — an owner, operator or employee of a health care facility from which you are receiving health care, or their spouse, parent, child or sibling — unless they would qualify as a surrogate under §5-605(a), or you appointed them before you received or contracted to receive care there. Also barred: anyone who is the subject of a protective order under which you are a person eligible for relief, and — with an exception — a spouse who has signed a separation agreement with you or where either of you has filed for divorce (§5-602(b)(3))

Delivery

A duty on you to notify, then a duty on the physician to file. "It shall be the responsibility of the declarant to notify the attending physician that an advance directive has been made" (§5-602(f)(1)); a physician who is notified "shall promptly" make it, or a copy, part of the medical records (§5-602(f)(2)). No delivery precondition — §5-602(e)(1) makes the directive effective on certification, not on receipt

Who decides

Your attending physician and a second physician, certifying in writing that you are incapable of making an informed decision. The second certification is not required if you are unconscious, or unable to communicate by any means (§5-602(e)(1)–(2))

Trigger overridable

Yes — §5-602(e)(1) begins "Unless otherwise provided in the document", and the state's form offers the choice: the agent's power takes effect immediately, or when your attending physician — or your attending physician and a consulting doctor — determine that you have lost the ability (form Part I(H))

Registry

No state registry is created in the captured sections. §5-602(c)(3) lets the State-designated health information exchange accept an unwitnessed electronic directive — a video record or file — if it is dated and stored by an electronic advance directives service recognised by the Maryland Health Care Commission

Age

18, or a person who under §20-102(a) has the same capacity as an adult to consent to medical treatment (§5-601(f))

Pregnancy

No automatic carve-out captured. Both halves of the state's form carry an optional pregnancy section for your own instructions — "Optional, for women of child-bearing years only; form valid if left blank" (§5-603, Parts I(F) and II(F))

Oral instructions

Yes — same effect as written. An oral advance directive made in the presence of the attending physician, a physician assistant or a nurse practitioner and one witness, and documented in the medical record, "shall have the same effect as a written or electronic advance directive" (§5-602(d))

Carried device

Nothing for the directive — see below

Citation

Md. Code Ann., Health-Gen. §5-601 et seq.

Read from the enacted statute, 2026-09-18.