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Medical Power of Attorney in Iowa: Durable Power of Attorney for Health Care and Living Will
Iowa's medical power of attorney and living will each need two qualified witnesses or an Iowa notary. Here is how both work, what changed on July 1, 2026, and what happens without them.
By naveen · Updated · How we research our guides
What to know
- Iowa's medical power of attorney is a durable power of attorney for health care (Iowa Code chapter 144B); its living will is a declaration under the Life-sustaining Procedures Act (chapter 144A).
- Each must be dated and either signed before two witnesses or acknowledged before a notarial officer in Iowa; at least one witness can't be related to your parent within the third degree.
- Your parent's attending health care provider, that provider's employees, anyone under 18 and the named agent can't witness a health care power of attorney.
- A 2026 law, in effect since July 1, 2026, lets an advanced registered nurse practitioner act as attending provider and extends the no-document decision list to other relatives and a close adult friend.
- Retirement Checklist puts these documents in order alongside everything else your family needs to settle.
A medical power of attorney in Iowa is a durable power of attorney for health care, valid when dated and either signed before two qualified witnesses or acknowledged before an Iowa notarial officer. Under Iowa Code 144B.1, it's a document "authorizing an attorney in fact to make health care decisions for the principal" when your parent can't make them. Iowa's living will is a "declaration" under the Life-sustaining Procedures Act, which directs that life-sustaining procedures be withheld or withdrawn in a terminal condition. The living will follows the same signing rule.
What is a durable power of attorney for health care in Iowa?
It names an agent, called the attorney in fact, to consent to, refuse or withdraw consent to health care when your parent can't decide. To work, it must explicitly authorize the agent to make health care decisions. An agent "who is known to the health care provider to be available and willing to make health care decisions has priority over any other person, including a guardian appointed pursuant to chapter 633" (Iowa Code 144B.6).
The agent follows your parent's wishes as stated in the document, in a living will, or otherwise made known to the agent, and otherwise acts in your parent's best interests. Since July 1, 2026, the agent's authority isn't limited by wishes your parent told someone else or wrote in another document, unless a separate section of the power of attorney says it is limited and lists the limits. The agent can also review your parent's medical records. A financial power of attorney is separate; see our Iowa power of attorney guide.
How is it different from a living will?
A health care power of attorney names someone to decide for your parent; a living will states your parent's own direction about life-sustaining procedures in a terminal condition.
| Document | What it does | Signing rule |
|---|---|---|
| Durable power of attorney for health care | Names an agent for health care decisions when your parent can't decide | Two witnesses, or an Iowa notarial officer (Iowa Code 144B.3) |
| Declaration (living will) | Directs that life-sustaining procedures be withheld or withdrawn if your parent's condition is terminal and they can't decide | Two witnesses, or an Iowa notarial officer (Iowa Code 144A.3) |
A life-sustaining procedure doesn't include medication or a procedure needed "to provide comfort care or to alleviate pain," and doesn't include nutrition or hydration unless given parenterally or through intubation. For the general picture, see power of attorney vs. advance directive.
How do you sign them in Iowa?
Both documents use the same signing rule: each must be dated and signed by your parent, or by someone acting at your parent's direction, and then either:
- signed by at least two witnesses who watched the signing "in the presence of each other" and your parent; or
- "acknowledged before a notarial officer within this state as provided in chapter 9B."
None of these people can be a witness:
- a health care provider attending your parent on the date of signing;
- an employee of that provider;
- anyone under 18;
- for the health care power of attorney, the person named as agent.
"At least one of the witnesses" must not be "a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity" (Iowa Code 144B.3). The living will has the same rule for its witnesses.
Who can't serve as the health care agent?
Under Iowa Code 144B.4, your parent can't name:
- "A health care provider attending the principal on the date of execution."
- An employee of that provider, unless the employee is related to your parent within the third degree.
Family members can serve, and your parent can name one or more alternates. If your parent names a spouse and the marriage is later dissolved, "the power is thereby revoked," and it's reinstated if they remarry each other.
When does the agent start making decisions?
Only when your parent can't make the decision, in the judgment of the attending provider. A 2026 law (House File 2305) defines the attending provider as a physician, physician assistant or advanced registered nurse practitioner licensed in Iowa. "If the principal objects to a decision to withhold or withdraw health care, the principal shall be presumed to be able to make a decision."
A living will applies only when your parent's condition is terminal and they can't make treatment decisions. The attending provider's determination of a terminal condition must be confirmed by another physician, advanced registered nurse practitioner or physician assistant. While your parent can decide, "A qualified patient has the right to make decisions regarding use of life-sustaining procedures as long as the qualified patient is able to do so."
Where do you get Iowa forms?
The Iowa Code itself prints optional forms, on the Iowa Legislature's website. Iowa Code 144B.5 gives a form for the durable power of attorney for health care, which includes the line "My agent has the right to examine my medical records and to consent to disclosure of such records." Iowa Code 144A.3 gives a short form titled "DECLARATION" for the living will. Neither form is required.
The chapter PDFs on the Iowa Legislature's site are the 2026 Code and still show the earlier wording, "attending physician"; House File 2305 changed it to "attending provider" from July 1, 2026. It's your parent's responsibility to tell their health care provider about the power of attorney and to give the provider the living will.
What happens if your parent has no health care power of attorney?
Iowa's statute sets a priority list for specific end-of-life decisions. Under Iowa Code 144A.7, as amended on July 1, 2026, life-sustaining procedures may be withheld or withdrawn from a patient in a terminal condition who can't communicate and has no living will, if the attending provider, another clinician and the decision-maker consult and agree in writing, with a witness present. The decision-maker is the agent or a guardian; if there is none, the first available of:
- your parent's spouse;
- an adult child, or a majority of adult children reasonably available;
- a parent, or both parents if both are available;
- an adult sibling, or a majority of adult siblings;
- a majority of other adult relatives, such as grandchildren, nieces and nephews;
- a close adult friend who has given the attending provider an affidavit.
The same order applies to withholding resuscitation in a health care facility or hospice facility, to asking for hospice admission, and to signing an IPOST for a patient who can't. The chapters we read don't set a general list for other health care decisions. Otherwise the route may be a guardianship; see conservatorship and guardianship.
How do you revoke an Iowa health care power of attorney or living will?
Your parent can revoke either one at any time, in any way they can communicate the intent. A health care power of attorney "may be revoked at any time and in any manner by which the principal is able to communicate the intent to revoke, without regard to mental or physical condition" (Iowa Code 144B.8). Your parent can tell the agent, or a health care provider who is treating them, orally or in writing, and "The principal is presumed to have the capacity to revoke."
A newer health care power of attorney revokes an earlier one unless it says otherwise. A living will "may be revoked at any time and in any manner by which the declarant is able to communicate the declarant's intent to revoke" (Iowa Code 144A.4). A revocation takes effect for a provider once it's communicated to them.
What about IPOST?
The Iowa Department of Health and Human Services describes IPOST, the Iowa Physician Orders for Scope of Treatment, as "a double-sided, one-page document that allows a person to communicate their preferences for key life-sustaining treatments including: resuscitation, general scope of treatment, artificial nutrition and more." It's for someone who is frail and elderly or has a chronic, critical medical condition or terminal illness. It's signed by your parent or their legal representative and by a physician, advanced registered nurse practitioner or physician assistant. A blank section means full treatment, and an IPOST doesn't override a living will or a health care power of attorney.
Frequently asked questions
Does a medical power of attorney need to be notarized in Iowa?
No, a notary is one of two options. Under Iowa Code 144B.3, a durable power of attorney for health care must be dated and either signed by two qualified witnesses or acknowledged before a notarial officer in Iowa. The living will follows the same rule under 144A.3. A financial power of attorney, by contrast, must be notarized.
Can a family member witness a medical power of attorney in Iowa?
One witness can be a relative, but at least one of the two must not be related to your parent by blood, marriage or adoption within the third degree. The named agent, your parent's attending health care provider, that provider's employees and anyone under 18 can't witness. Signing before an Iowa notary instead avoids the witness rules.
Where can I get an Iowa medical power of attorney form?
Iowa Code 144B.5 prints an optional form for the durable power of attorney for health care, and 144A.3 prints an optional living will declaration. Both are on the Iowa Legislature's website. An attorney can also prepare one. Whatever the form, your parent signs and dates it before two qualified witnesses or an Iowa notary.
Who makes medical decisions in Iowa if there's no power of attorney?
For end-of-life decisions about life-sustaining procedures, Iowa Code 144A.7 sets an order: a guardian, then the spouse, adult children, parents, adult siblings, other adult relatives and a close adult friend. The chapters we read don't set a general list for other decisions. Naming an agent lets your parent choose instead.
Is an advance directive from another state valid in Iowa?
Yes, to the extent it's consistent with Iowa law. Under Iowa Code 144B.3 and 144A.3, a health care power of attorney or living will signed in another state in compliance with that state's law is valid in Iowa. So is one signed by a veteran that meets the federal Department of Veterans Affairs advance directive requirements.
Can my parent change their mind after signing?
Yes. Your parent can revoke a health care power of attorney or a living will at any time and in any manner they can communicate, regardless of their mental or physical condition. Telling the agent and the treating provider, orally or in writing, makes it effective for them. A newer health care power of attorney replaces an older one.
Getting started
A health care power of attorney only helps if it's signed while your parent can sign it, with the right witnesses or a notary, and if the doctor and agent know about it. The plan this site builds asks four questions, including which state your parents live in, and puts the steps that matter most for your family in order. It's free and takes about 90 seconds.
Related guides
Sources
- Iowa Code chapter 144B, Durable power of attorney for health care: definitions (144B.1), signing and witnesses (144B.3), who can't be agent (144B.4), the form (144B.5), the agent's priority and duties (144B.6), revocation (144B.8) and divorce (144B.12).
- Iowa Code chapter 144A, Life-sustaining Procedures Act: the declaration (144A.3), revocation (144A.4), terminal condition (144A.5) and decisions without a declaration (144A.7).
- Iowa House File 2305 (2026): the attending provider definition, the expanded decision-maker list and other amendments in effect July 1, 2026.
- Iowa Senate File 2198 (2026): the agent's authority under 144B.6, in effect July 1, 2026.
- Iowa Code chapter 144D, Physician orders for scope of treatment: the IPOST statute.
- Iowa Department of Health and Human Services, IPOST: what IPOST is and the form.
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