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Medical Power of Attorney in Tennessee: The Advance Directive for Health Care
In Tennessee, a medical power of attorney is part of an advance directive, signed before a notary or two qualified witnesses. Here is how it works under the Tennessee Health Care Decisions Act, and what happens without one.
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What to know
- A Tennessee advance directive can name a health care agent; it must be in writing, signed by your parent, and either notarized or witnessed by two witnesses (Tenn. Code Ann. § 68-11-1803).
- Neither witness can be the agent, and at least one must be unrelated to your parent and not entitled to any part of their estate.
- The state publishes a free Advance Directive for Health Care form that combines the medical power of attorney and the living will.
- Without an agent, the supervising health care provider identifies a surrogate, considering a spouse first, then an adult child, a parent and an adult sibling (§ 68-11-1806).
- Retirement Checklist puts these documents in order alongside everything else your family needs to settle.
A medical power of attorney in Tennessee is the part of an advance directive that names an agent, someone "designated in an advance directive for health care to make a health care decision" for your parent. Under the Tennessee Health Care Decisions Act, now Tenn. Code Ann. §§ 68-11-1801 to 68-11-1815, the agent can make "any health care decision the principal could have made while having capacity." The state's form says your parent's signature "must either be witnessed by two competent adults" or by a notary public.
What is a medical power of attorney in Tennessee?
In Tennessee, a medical power of attorney is a "power of attorney for health care": "the designation of an agent to make health care decisions for the individual granting the power." It's one kind of what the law calls an advance directive: "an individual instruction or a written statement relating to the subsequent provision of health care for the individual, including, but not limited to, a living will or a durable power of attorney for health care."
The agent follows your parent's instructions and known wishes, and otherwise decides in their best interest, considering their personal values. The agent's decisions are "effective without judicial approval," and, unless a court orders otherwise, they take precedence over a guardian's. This is separate from a financial power of attorney; see our Tennessee power of attorney guide.
How is it different from a living will?
A medical power of attorney names someone to make decisions, while a living will records your parent's wishes about treatment; since May 9, 2017, Tennessee's state form puts both in one document. The older forms still count.
| Document | What it does | Signing rule |
|---|---|---|
| Advance Directive for Health Care (state form) | Names an agent and records treatment wishes in one form | Notary, or two qualified witnesses (§ 68-11-1803) |
| Durable power of attorney for health care (older, Title 34) | Names an attorney in fact for health care | Notary, or two qualified witnesses (§ 34-6-203) |
| Living will (older, Title 32) | Directs withholding or withdrawal of medical care | Notary, or two qualified witnesses (§ 32-11-104) |
The state's advance directive FAQ says "Any Living Will or Medical Power of Attorney completed prior to July 1, 2004 will be honored." For the general picture, see power of attorney vs. advance directive.
How do you sign a Tennessee advance directive?
Under § 68-11-1803(b), "The advance directive must be in writing and signed by the principal. The advance directive must either be notarized or witnessed by two (2) witnesses." Any adult or emancipated minor can make one.
If your parent uses witnesses instead of a notary:
- each witness must be a competent adult who isn't the agent;
- at least one must not be related to your parent by blood, marriage or adoption;
- that same witness must not be entitled to any part of your parent's estate, under an existing will or codicil or by law.
The document also needs an attestation clause in which the witnesses confirm they qualify; the state form prints one for each witness. The form adds that neither witness may be the agent or the alternate agent. A family member can serve as one witness, as long as the other meets every rule.
Where do you get the Tennessee form?
The Tennessee Health Facilities Commission publishes the Advance Directive for Health Care in English and Spanish. The form says it "replaces the old forms for durable power of attorney for health care, living will, appointment of agent, and advance care plan." It has five parts: the agent and an alternate, quality-of-life and treatment wishes, other instructions, organ donation, and signatures with a witness block and a notary block.
The state's FAQ says the form "can be created without the assistance of a lawyer," and that your parent should give one copy each "to your agent, your successor agent, your doctor, and your local hospital." It also notes that a photocopy is legally valid.
When does the agent start making decisions?
Unless the document says otherwise, "the authority of an agent becomes effective only upon a determination that the principal lacks capacity, and ceases to be effective upon a determination that the principal has recovered capacity." Your parent's designated physician makes that determination.
The state form lets your parent choose differently: one box gives the agent permission to decide "at any time, even if I have capacity to make decisions for myself." The form also names the agent as your parent's personal representative under HIPAA.
Who can't serve as the health care agent?
Section 68-11-1803, as we read it, doesn't list people barred from serving as an agent under an advance directive. Other rules do limit who can act:
- Under the older durable power of attorney for health care, a 2013 law bars certain employees and operators of a treating health care institution from serving as attorney in fact.
- A surrogate can't be your parent's treating provider, an operator of the health care institution, or an employee of either, unless the employee is a relative (§ 68-11-1806(g)).
The state's FAQ advises: "Do not choose your doctor, or another person who is likely to be your future health care provider, as your agent or successor agent."
What happens if your parent has no agent?
Tennessee uses a surrogate. Your parent can name one by telling the supervising health care provider, orally or in writing. Otherwise, under § 68-11-1806, the supervising provider identifies a surrogate and records it in the clinical record. The surrogate must be an adult who "has exhibited special care and concern for the patient," knows their values, is reasonably available and is willing to serve. "Consideration may be given in order of descending preference" to:
- the spouse, unless legally separated;
- an adult child;
- a parent;
- an adult sibling;
- any other adult relative;
- any other adult who meets the requirements.
The provider also weighs who can best follow your parent's wishes, regular contact, and availability to visit and meet with providers. If no one is available, the designated physician can decide after consulting the facility's ethics process or getting a second, independent physician's agreement. A surrogate your parent didn't choose can withhold artificial nutrition and hydration only if two physicians certify it "is merely prolonging the act of dying and the patient is highly unlikely to regain capacity to make medical decisions."
How do you revoke a Tennessee advance directive?
Your parent can revoke it while they have capacity, and the method depends on which part they're revoking (§ 68-11-1804).
- The agent. Your parent can revoke an agent's designation "only by a signed writing or by personally informing the supervising health care provider" (§ 68-11-1804).
- The rest of the directive. Your parent can revoke all or part of it "at any time and in any manner that communicates an intent to revoke."
- Divorce. A decree of annulment, divorce, dissolution or legal separation revokes the designation of a spouse as agent, unless the decree or directive says otherwise.
- A newer directive. A later directive revokes an earlier one to the extent they conflict.
The state's FAQ says the best way to change a directive is to create a new one, then collect and destroy copies of the old version.
What rights does the agent have at the hospital?
An agent has a right to visit your parent in the hospital, and a patient or their authorized representative can get copies of medical records within ten working days of a written request, under two laws effective July 1, 2024. Under 2024 Public Chapter 766, an agent "has a right to in-person visitation with the principal at a hospital where the principal is located to evaluate the principal's condition," with at least one visit a day during regular visiting hours, and a declared emergency can't cut off that right. Your parent can limit it.
Under 2024 Public Chapter 831, a health care provider must give a patient or their authorized representative a copy of the patient's medical records "within ten (10) working days of receipt of a written request."
What about POST?
POST, Physician Orders for Scope of Treatment, is a medical order rather than an advance directive. Under Tenn. Code Ann. § 68-11-224, it's signed by your parent's physician (or, in limited discharge and transfer situations, a physician assistant or advanced practice nurse) with consent from your parent or their agent or surrogate, and it records whether to attempt CPR and other treatment choices.
The state's POST FAQ explains why both matter: "First responders cannot follow end of life wishes contained only in an advance directive like a living will," and "An advance directive is still necessary to appoint a legal health care decision maker."
Frequently asked questions
Does a medical power of attorney need to be notarized in Tennessee?
Not necessarily. Under Tenn. Code Ann. § 68-11-1803, an advance directive naming a health care agent must either be notarized or witnessed by two witnesses. Your parent can choose either option. The state's Advance Directive for Health Care form includes a block for each, and only one needs to be completed.
Who can witness an advance directive in Tennessee?
Any competent adult who isn't the agent or alternate agent. At least one of the two witnesses must not be related to your parent by blood, marriage or adoption, and must not be entitled to any part of their estate under a will or by law. The other witness can be a relative, as long as they aren't the agent.
Where can I get a Tennessee advance directive form?
The Tennessee Health Facilities Commission publishes the free Advance Directive for Health Care form, in English and Spanish, on tn.gov. It combines the medical power of attorney and the living will, and the state says it can be completed without a lawyer. Give copies to the agent, the alternate, your parent's doctor and their hospital.
Who makes medical decisions in Tennessee if there's no advance directive?
A surrogate. Your parent can name one by telling the supervising provider. Otherwise the provider identifies one, giving consideration in order to a spouse who isn't legally separated, an adult child, a parent, an adult sibling, another adult relative, then another qualified adult. The person must have shown special care and concern and be willing to serve.
Is an advance directive from another state valid in Tennessee?
Under § 68-11-1803(h), an advance directive signed outside Tennessee by someone who wasn't a Tennessee resident at the time is given effect if it complies with Tennessee's law or the law of the state where your parent lived. If your parent has moved to Tennessee, an attorney can confirm whether a new Tennessee form makes sense.
Can my parent change their mind after signing?
Yes. While they have capacity, your parent can revoke an agent's designation by a signed writing or by telling the supervising health care provider, and can revoke the rest of the directive in any way that shows that intent. A newer directive replaces an older one where they conflict, and divorce revokes a spouse's appointment.
Getting started
An advance directive only helps if it's signed while your parent can sign it, before a notary or two qualified witnesses, and if copies reach the agent and the doctor. 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
- 2004 Tennessee Public Chapter 862, Tennessee Health Care Decisions Act: definitions, signing, the agent, revocation, out-of-state directives and surrogates, now Tenn. Code Ann. §§ 68-11-1801 to 68-11-1815.
- Tennessee Attorney General, Opinion No. 05-093: where the Act is codified.
- 2007 Tennessee Public Chapter 8: signing rules for the older living will and durable power of attorney for health care.
- Tennessee Health Facilities Commission, Health Care Decision Making: the Advance Directive for Health Care form, the surrogate form and the POST form.
- Tennessee Health Facilities Commission, Advance directives FAQ: plain-language guidance on the form, witnesses and copies.
- Tennessee Health Facilities Commission, POST FAQ: how POST and advance directives work together.
- 2013 Tennessee Public Chapter 254: Physician Orders for Scope of Treatment (§ 68-11-224).
- 2024 Tennessee Public Chapter 766: an agent's hospital visitation right.
- 2024 Tennessee Public Chapter 831: copies of medical records within ten working days.
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