Illinois: Living Will and Advance Health-Care Instruction Requirements
The short answer
Illinois uses a written Living Will Act declaration, in hard-copy or electronic form, signed by the declarant or a directed signer before two witnesses age 18 or older; the Act requires no notary. It operates only when valid and unrevoked, the patient cannot direct care, and an attending physician has personally examined and verified a terminal condition in writing. An available authorized health-care agent takes priority over the declaration.
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This is the general rule in Illinois. Ezel applies current Illinois law to your specific facts and answers with citations to the statutes.
| Governing law and document | 755 ILCS 35, Illinois Living Will Act. Standalone written declaration directing that death-delaying procedures not prolong life in a terminal condition; § 3(e) supplies an optional form. It is distinct from a health-care agency and from POLST |
|---|---|
| Who may make an instruction | Individual of sound mind who has reached majority or is emancipated under the Emancipation of Minors Act (§ 3(a)); another person may sign at the declarant's direction (§ 3(b)) |
| Oral, written, and signature form | Written declaration in hard-copy or electronic format; declarant or directed signer signs (§§ 2(b), 3(b)). The Act does not recognize an oral execution route or require a date outside its optional form. Section 9(i) permits technology-neutral electronic creation and signing that meets its authentication standard |
| Witness, notary, and disqualifications | Two witnesses, each age 18+ (§ 3(b)); no statutory notary route. The mandatory rule states no relationship or financial disqualification. The optional § 3(e) form instead has each witness attest to presence/acknowledgment and that the witness is not an estate taker or directly responsible for care |
| Covered conditions and trigger | Valid and unrevoked declaration; patient unable to direct use of life-sustaining/death-delaying procedures; and qualified-patient status (§ 9.5), subject to agent priority. Qualified status requires attending physician's personal exam and written diagnosis/verification of an incurable, irreversible terminal condition with imminent death and treatment only prolonging dying (§ 2(g)-(h)) |
| Treatment, nutrition, hydration, and comfort | May direct withholding or withdrawal of death-delaying procedures, including ventilation, dialysis, IV feeding/medication, transfusions, and tube feeding. Comfort care and pain relief remain required. Nutrition/hydration may not be withheld if death would result solely from dehydration/starvation rather than the terminal condition (§ 2(d)) |
| Pregnancy and other statutory limits | A qualified patient's declaration has no force while the attending physician believes continued death-delaying procedures could permit fetal development to live birth (§ 3(c)). The Act does not authorize mercy killing or an affirmative/deliberate act or omission to end life beyond natural dying (§ 9(f)) |
| Revocation, notice, and registry | Declarant may revoke anytime regardless of condition by intentional destruction/defacement, signed dated hard-copy or electronic writing, witnessed expression, or qualifying electronic deletion (§ 5). Effective when declarant or revocation witness communicates it to attending physician, who records time/date/place. No living-will registry; 15 ILCS 305/34's registry, due by January 1, 2027, is POLST-only |
| Provider duties, recognition, and effect | Current wishes always supersede the declaration (§ 7). Provider may rely on and, subject to the Act, must comply with an apparent/immediately available operative declaration (§ 9(k)). A refusing physician uses §§ 3(d) and 6 notice/transfer process. Foreign declaration valid if compliant where made or Illinois law, then applied under Illinois Act (§ 9(h)) |
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Illinois uses a narrow, standalone Living Will Act declaration for a terminal
condition. It is the adult's treatment instruction, not an appointment of a
health-care agent and not a POLST or other clinician order.
Requirements one by one
The declaration is a witnessed writing
Under 755 ILCS 35/3, a person of sound mind who has reached majority or is
emancipated may execute the declaration. The declarant signs, or another person
signs at the declarant's direction, and two witnesses age 18 or older attest.
The Act requires no notary.
The mandatory execution subsection states no relationship or financial
disqualification for a witness. The optional statutory form is narrower in
practice: its witness paragraph recites that the witness is not entitled to the
declarant's estate and is not directly responsible for the declarant's medical
care. Because § 3(e) says the printed form need not be used, those recitals
should not be converted into extra mandatory execution terms.
The declaration may be in hard-copy or electronic form. § 9(i) permits
technology-neutral electronic creation and signing using a securely maintained
unique identifier and a system meeting the stated authentication standard. The
Act does not create an oral living-will route. Its optional form is dated, but
the mandatory signature rule itself does not require a date.
Operation requires inability to direct care and a terminal condition
§ 9.5, added by P.A. 104-378 effective January 1, 2026, separates execution
from operation. The declaration must be validly executed and unrevoked, the
patient must be unable to direct the use of life-sustaining or death-delaying
procedures, and the patient must be “qualified.”
Qualified status requires the attending physician to have personally examined
the patient and diagnosed and verified in writing an incurable and irreversible
terminal condition. Death must be imminent, with death-delaying procedures
serving only to prolong the dying process. The Act does not require a second
physician.
An available agent authorized under a health-care agency takes priority.
§ 3.5 says the living will is not operative while that agent is available
and authorized to decide about life-sustaining or death-delaying procedures.
Treatment has a separate nutrition and hydration limit
A declaration may direct that death-delaying procedures be withheld or
withdrawn. § 2(d) lists assisted ventilation, artificial-kidney treatment,
intravenous feeding or medication, transfusions, and tube feeding as possible
examples when they serve only to postpone death.
Comfort care and pain relief remain the provider's responsibility. Nutrition
and hydration may not be withheld when doing so would cause death solely from
dehydration or starvation rather than from the existing terminal condition.
Pregnancy uses a possible-live-birth test
Under § 3(c), a qualified patient's declaration has no force while the
attending physician believes continued death-delaying procedures could permit
the fetus to develop to the point of live birth. The provision states no week,
trimester, or separate viability threshold.
Section 9(f) also says the Act does not authorize mercy killing or an
affirmative or deliberate act or omission to end life beyond permitting the
natural process of dying under the Act.
Revocation is broad but notice runs to the attending physician
The declarant may revoke at any time regardless of mental or physical
condition. § 5 allows intentional destruction or defacement; a signed and
dated hard-copy or electronic revocation; an oral or other expression made
before an adult witness who signs and dates a confirming writing; or deletion
of an electronic declaration in the manner and system the section describes.
Revocation becomes effective when the declarant or a witness to the revocation
communicates it to the attending physician. The physician records the time,
date, and place of notification in the medical record.
The Living Will Act creates no living-will registry. A separate Secretary of
State registry required by January 1, 2027 accepts only completed Illinois
POLST forms under 15 ILCS 305/34, not living-will declarations.
Current wishes control, and refusal follows a notice route
The patient's current desires always supersede the declaration under § 7.
Subject to the Act, § 9(k) permits reliance on and requires compliance with an
apparent and immediately available declaration once the patient is qualified
and cannot direct care.
If the attending physician will not comply and the patient can act, § 3(d)
places responsibility for initiating transfer on the patient. If the patient
cannot act, the physician must promptly notify, in order, an authorized person,
a guardian, or available family to arrange transfer. Sections 3(d) and 6 also
require the declaration and terminal-condition determination to be recorded as
specified.
Illinois treats an out-of-state declaration as validly executed when it
complied with the law of that state or Illinois law, but applies it under the
Illinois Act (§ 9(h)).
What trips people up
- The trigger is terminal condition, not permanent unconsciousness. The
Living Will Act does not use the broader condition list found in some other
advance-directive statutes. - An authorized available agent takes priority. The 2026 operation rule
makes that relationship express. - Nutrition and hydration are not an unrestricted checkbox. Section 2(d)
preserves them when withdrawal would cause death solely by dehydration or
starvation. - The named registry is POLST-only. It does not create a filing system for
this declaration.
Common questions
Must an Illinois living will be notarized?
No. Section 3(b) requires two witnesses age 18 or older and states no notary
alternative.
May the declaration be electronic?
Yes. Sections 2(b) and 9(i) recognize electronic declarations and electronic
signing when the authentication standard is met.
Can I revoke after losing capacity?
Yes. Section 5 permits revocation at any time without regard to mental or
physical condition, using one of its listed methods.
Will another state's declaration work in Illinois?
It is validly executed if it complied with that state's law or Illinois law,
but Illinois applies the declaration under the Illinois Living Will Act.
Statutes and sources
- 755 ILCS 35/2-7 and 35/9-9.5 — definitions, execution, agent priority,
operation, treatment, pregnancy, revocation, provider process, electronic
documents, and interstate recognition. Official Illinois Living Will Act
(accessed 2026-07-30). - 15 ILCS 305/34 — future Secretary of State registry limited to POLST
forms. Official Secretary of State Act
(accessed 2026-07-30).
Source links
Every statute quoted above, linked, with the date we checked it.
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