District of Columbia: Health Care Power of Attorney Requirements

In the District of Columbia the medical decision-making document is a durable
power of attorney for health care, governed by the Health-Care Decisions Act at
D.C. Code §§ 21-2201 to 21-2213. It is a standalone document — separate from a
living will — in which a competent adult (the "principal") names an
attorney-in-fact (the agent) to make health-care decisions if the principal
later cannot. This page is about executing that appointment.

Requirements one by one

Governing law and document

The Act sets out what the document must say and do, and it supplies an optional
fill-in statutory form at § 21-2207. Under § 21-2205(a), "[a] competent adult may
designate, in writing, an individual who shall be empowered to make health-care
decisions on behalf of the competent adult," effective if the adult "becomes
incapable, by reason of mental disability," of making or communicating a decision.

Who can sign

The signer must be a competent adult (§§ 21-2202(6), 21-2205(a)). Capacity is
presumed (§ 21-2203), and there is a specific "rebuttable presumption ... that a
principal has the capacity" to make and revoke the document (§ 21-2208(c)). The
document must be dated and signed by the principal (§ 21-2205(c)), and it must
carry durable language — either "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" (§ 21-2205(b)).

Witnesses or notary

The District requires two adult witnesses and no notary. Section 21-2205(c)
provides that the document "shall be dated and signed by the principal and 2 adult
witnesses who affirm that the principal was of sound mind and free from duress at
the time of signing." A notarization is not part of the statutory requirement,
though it does no harm to add one.

There is also a relationship rule for the witnesses. Under § 21-2205(d), "at
least 1" of the two witnesses "shall not be related to the principal by blood,
marriage or adoption and shall not be entitled to any part of the estate of the
principal." One relative can witness, but not both.

Who can't witness or serve

The witness bar in § 21-2205(c) disqualifies "the principal, the health-care
provider of the principal or an employee of the health-care provider," and the agent
cannot be one of the two witnesses either. On top of that, at least one witness must
be an unrelated non-heir (§ 21-2205(d)).

On who may serve as agent, the District's main rule targets a specific pressure
point: after a patient "has spent at least 48 hours in a health care facility," a
provider may ask the patient to sign a DPOA, but "[t]he health care provider may not
be named as the attorney in fact" (§ 21-2209(b)). No provider may require a DPOA as a
condition of care at all (§ 21-2209(a)).

When the agent can act

The authority is springing. By definition the DPOA is "effective upon, and only
during incapacitation" (§ 21-2202(3)(B)), and § 21-2206(b)(2) confirms the agent
"shall not have the authority to make a particular health-care decision, if the
principal is able to give or withhold informed consent." Incapacity is not a casual
determination: § 21-2204 requires certification by two licensed professionals —
"one ... a physician and one ... a qualified psychologist or psychiatrist" — at
least one of whom examined the principal "within 1 day preceding certification," with
both giving a written opinion on the cause, nature, extent, and probable duration of
the incapacity.

Agent's powers and limits

Once the power is in effect, the attorney-in-fact "shall have all the rights, powers
and authority related to health-care decisions that the principal would have"
(§ 21-2206(a)), including consenting to, refusing, or withdrawing any treatment,
reviewing records, choosing or discharging providers, and directing admission or
discharge — all "[s]ubject to any express limitations" you write into the document.
The agent must act on your wishes as expressed in the document, or on a good-faith
view of your best interests if your wishes are unknown (§ 21-2206(c)). One
across-the-board limit: DC bars any substitute decision-maker from consenting to
"an abortion, sterilization or psycho-surgery," or to "convulsive therapy or behavior
modification programs involving aversive stimuli," "unless authorized by a court"
(§ 21-2211).

How to revoke

While you have capacity you may revoke at any time. Section 21-2208(a) lets you
revoke the appointment "by notifying the attorney in fact orally or in writing," or
revoke the agent's authority "by notifying the health-care provider orally or in
writing." A later valid DPOA revokes an earlier one (§ 21-2208(d)). And if your
"marriage or domestic partnership ... is dissolved, annulled, or terminated" after
you sign, that event "shall automatically" revoke a former spouse or domestic partner
as your attorney-in-fact unless the document says otherwise (§ 21-2208(e)).

Out-of-state directives

A directive from elsewhere counts. The Act's definition of a durable power of
attorney for health care expressly includes one "validly executed in another
jurisdiction pursuant to similar provisions of the law of that jurisdiction"
(§ 21-2202(3)(A)).

What trips people up

• You need two witnesses, and at least one can't be family or an heir. A notary
  is not a substitute (§ 21-2205(c)). Using two relatives — or two people who would
  inherit from you — fails the § 21-2205(d) rule that at least one witness be an
  unrelated non-heir.
• Your doctor and their staff can't witness. The principal's health-care provider
  and that provider's employees are disqualified as witnesses (§ 21-2205(c)).
• The agent acts only after two clinicians certify incapacity. DC does not let
  the agent step in on a single doctor's say-so; it takes a physician plus a
  psychologist or psychiatrist, in writing (§ 21-2204). Until then, you keep making
  your own decisions (§ 21-2206(b)(2)).
• Divorce cancels a spouse-agent. A divorce, annulment, or dissolution — or the
  end of a domestic partnership — automatically revokes a former spouse or partner as
  your agent unless your document says to keep them (§ 21-2208(e)).

Common questions

Does a DC health care power of attorney need to be notarized?
No. It needs two adult witnesses, at least one of whom is unrelated to you and not an
heir (§ 21-2205(c)–(d)). Notarization is optional.

Can my doctor be my agent?
Not in the situation the statute regulates: if a provider asks you to sign after
you've been in a facility 48 hours, that provider "may not be named as the attorney
in fact" (§ 21-2209(b)). Choosing your own treating provider as agent is generally a
bad idea for the same conflict reasons.

When does my agent's authority start?
Only once two professionals — a physician and a psychologist or psychiatrist —
certify in writing that you cannot make health-care decisions (§ 21-2204). Before
that, your own decisions control (§ 21-2206(b)(2)).

Will a health care POA I signed in another state work in DC?
Yes, if it was validly executed under that state's similar law. DC's definition of a
durable power of attorney for health care includes out-of-jurisdiction documents
(§ 21-2202(3)(A)).

Statutes and sources

• D.C. Code § 21-2202 — definitions, including a durable power of attorney for
  health care (which covers an out-of-jurisdiction document) and "incapacitated
  individual."
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2202 (accessed 2026-07-16)
• D.C. Code § 21-2204 — certification of incapacity by a physician and a
  qualified psychologist or psychiatrist.
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2204 (accessed 2026-07-16)
• D.C. Code § 21-2205 — execution of the DPOA: writing, durable language, dated,
  signed, two adult witnesses, and the unrelated-witness rule.
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2205 (accessed 2026-07-16)
• D.C. Code § 21-2206 — the attorney-in-fact's rights and duties and the limit
  while the principal can still consent.
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2206 (accessed 2026-07-16)
• D.C. Code § 21-2208 — revocation, including automatic revocation of a
  spouse/partner agent on divorce or dissolution.
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2208 (accessed 2026-07-16)
• D.C. Code § 21-2209 — no provider may compel a DPOA; a provider requesting one
  after 48 hours cannot be named agent.
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2209 (accessed 2026-07-16)
• D.C. Code § 21-2211 — decisions requiring a court order (abortion,
  sterilization, psychosurgery, convulsive or aversive therapy).
  https://code.dccouncil.gov/us/dc/council/code/sections/21-2211 (accessed 2026-07-16)