Wisconsin: Living Will and Advance Health-Care Instruction Requirements
The short answer
Wisconsin uses a written, witnessed 'Declaration to Health Care Professionals' for a person of sound mind who is at least 18. The adult signs before two fully disinterested adult witnesses, with a directed-signature and lawyer-supervised remote-witness route available; Chapter 154 does not provide a notary substitute. The declaration governs life-sustaining procedures and feeding tubes after two clinicians certify a terminal condition or persistent vegetative state, but it has no effect during pregnancy.
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This is the general rule in Wisconsin. Ezel applies current Wisconsin law to your specific facts and answers with citations to the statutes.
| Governing law and document | Wis. Stat. ch. 154, subch. II (§§ 154.02–154.15): written 'Declaration to Health Care Professionals' (Wisconsin Living Will). The § 154.03(2) statutory form is optional in form and substance. Separate from ch. 155 health-care-agent appointment and DNR orders. |
|---|---|
| Who may make an instruction | Any person of sound mind who is age 18+ may execute (§ 154.03(1)). Chapter 154 does not create a separate post-diagnosis oral route; a directed signer may sign only for a physically unable adult at the adult's express direction and in the adult's presence. |
| Oral, written, and signature form | Written and signed by the adult before 2 witnesses; if physically unable, a witness or other person signs the adult's name at express direction and in the adult's presence, with signing or acknowledgment before both witnesses (§ 154.03(1)). No oral declaration or general e-signature route. Lawyer-supervised, real-time audiovisual presence is permitted under § 154.03(3)'s Wisconsin-location, identity, delivery/counterpart, and affidavit conditions. |
| Witness, notary, and disqualifications | 2 witnesses, each age 18+; neither may be related by blood/marriage/adoption, know of an estate entitlement or claim, be directly financially responsible for care, or be a serving provider or disallowed provider/facility employee (§ 154.03(1)). Chaplains and social workers are excepted from the employee bar. The form says all 3 sign at the same time. No notary alternative. |
| Covered conditions and trigger | Terminal condition or persistent vegetative state, diagnosed and certified in writing by 2 health care professionals who personally examine the adult; one must be the attending professional and one a physician (§§ 154.01, 154.02). No separate incapacity certification: the declaration takes effect on execution, but a competent qualified patient's current desires always supersede (§§ 154.03(1), 154.07(2)). |
| Treatment, nutrition, hydration, and comfort | May authorize withholding/withdrawal of life-sustaining procedures or feeding tubes (§ 154.03). Life-sustaining procedure excludes pain relief and all nutrition/hydration; feeding tube is separately defined. Withdrawal cannot be authorized if it causes pain or reduced comfort that pain relief cannot alleviate; non-tube nutrition/hydration may be withdrawn only if medically contraindicated. The statutory form defaults unchecked feeding-tube and persistent-vegetative-state treatment boxes to use. |
| Pregnancy and other statutory limits | A qualified patient's declaration has no effect during pregnancy once the attending professional diagnoses pregnancy, with no viability or prognosis exception stated (§ 154.07(2)). The subchapter does not authorize an affirmative or deliberate act to end life beyond permitting natural dying (§ 154.11(6)). |
| Revocation, notice, and registry | Revoke anytime by directed physical destruction, signed dated writing, verbal expression, or later declaration (§ 154.05). Verbal revocation becomes effective only when the attending professional is notified; that professional records revocation and notice details. The adult notifies the attending professional of the declaration, which enters the chart (§ 154.03). Optional fee-based safekeeping with the county register in probate creates no presumption if omitted (§ 154.13). |
| Provider duties, recognition, and effect | A refusing professional must make a good-faith transfer attempt or commits unprofessional conduct; providers receive the stated immunity, including for unknown revocations (§ 154.07). Current competent wishes control. Original, legible photocopy, or electronic facsimile is presumed valid and goes in the medical record; an out-of-state document is enforceable to the extent consistent with Wisconsin law (§ 154.11(5m), (8)–(9)). |
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Wisconsin calls its living will a Declaration to Health Care Professionals.
It is the adult's own instruction under Chapter 154. A health care power of
attorney that appoints an agent is a separate Chapter 155 document.
Requirements one by one
Execution uses a signed writing and two disinterested witnesses
Under § 154.03(1), a person of sound mind who is at least 18 may execute the
declaration. The adult signs in the presence of two witnesses. If physically
unable to sign, a witness or another person may sign the adult's name at the
adult's express direction and in the adult's presence; that proxy signing must
occur or be acknowledged before both witnesses.
Every witness must be at least 18 and unrelated by blood, marriage, or adoption.
Neither may know of an estate entitlement or claim, be directly financially
responsible for the adult's care, or be the adult's serving provider or a barred
provider or inpatient-facility employee. Chaplains and social workers are
excepted from the employee bar. The statutory form tells the adult and both
witnesses to sign at the same time. Chapter 154 does not offer notarization as a
substitute.
Remote witnessing is a supervised presence rule
Section 154.03(3) treats simultaneous two-way, real-time audiovisual
appearance as presence only after a detailed process. A Wisconsin lawyer must
supervise; the adult and both remote witnesses must be physically in Wisconsin,
identify themselves, and participate in real time. The section also controls
the signed originals or counterparts, their delivery, and the supervising
lawyer's attached affidavit of compliance.
This is not a general click-to-sign route. The statute preserves a witnessed
document assembled through the specified remote process.
Two medical findings activate the treatment framework
A qualified patient under § 154.02(3) has been personally examined and
certified in writing as having a terminal condition or persistent vegetative
state by two health care professionals. One must be the attending health care
professional and one must be a physician.
The declaration takes effect on execution, but Chapter 154 does not use the
separate incapacity-certification trigger found in Wisconsin's health care POA
law. Instead, § 154.07(2) says a competent qualified patient's current
desires supersede the declaration at all times.
Life-sustaining procedures and feeding tubes are separate
Section 154.01(5) defines a life-sustaining procedure as one that only
prolongs dying without averting death. It includes respiratory assistance,
artificial maintenance of blood pressure and heart rate, transfusion, dialysis,
and similar procedures. It expressly excludes pain relief and all nutrition or
hydration.
That is why § 154.03 regulates feeding tubes separately. The statutory form
offers distinct feeding-tube choices and says an unchecked feeding-tube box
means the tube will be used. For persistent vegetative state, an unchecked
life-sustaining-procedure box likewise means the procedures will be used.
The adult cannot authorize withdrawal if it would cause pain or reduced comfort
that pain-relief measures cannot alleviate. Nutrition or hydration received by
means other than a feeding tube may be withdrawn only when the attending
professional says it is medically contraindicated.
The declaration has no effect during pregnancy
Section 154.07(2) says that once the attending health care professional
diagnoses pregnancy, the qualified patient's declaration “has no effect during
the course” of the pregnancy. The text states no viability, gestational-age,
live-birth, or prognosis exception.
Section 154.11(6) separately says the subchapter does not authorize an
affirmative or deliberate act to end life beyond permitting natural dying.
Verbal revocation needs notice, not two witnesses
Under § 154.05, the adult may revoke at any time by destroying the document
or directing its destruction in the adult's presence, signing and dating a
written revocation, verbally expressing revocation, or executing a later
declaration. A verbal revocation becomes effective only when the adult or
someone acting for the adult notifies the attending health care professional.
The professional records when and where the revocation occurred and when and
where notice arrived.
The adult is responsible for telling the attending professional that the
declaration exists, and the document then enters the medical record. Wis.
Stat. § 154.13 also allows optional, fee-based safekeeping with the county
register in probate; not filing creates no presumption about the adult's wishes.
Refusal requires a good-faith transfer attempt
Section 154.07 protects providers participating under the subchapter and
protects failure to act on a revocation unless the person or facility actually
knows of it. A professional who will not comply with a qualified patient's
declaration must make a good-faith effort to transfer the patient to a
professional who will comply; refusing or failing to try is unprofessional
conduct.
Under § 154.11, an original, legible photocopy, or electronic facsimile copy
is presumed valid and a provider or facility receiving it places it in the
medical record. A document validly executed elsewhere is enforceable only to
the extent it is consistent with Wisconsin law.
One clinician definition changes September 1, 2026
The certified Chapter 154 PDF shows the current § 154.01(1g) definition of
advanced practice registered nurse and flags its replacement effective
September 1, 2026, under 2025 Wisconsin Act 17. The future provision changes
the referenced APRN licensure definition to an individual licensed under
§ 441.09. It does not change the declaration's two witnesses or its requirement
for two certifying health care professionals, one attending and one physician.
What trips people up
- Every witness must be disinterested. Wisconsin does not use a one-
disinterested-witness compromise; both must clear every § 154.03 bar. - Feeding tubes are not part of the life-sustaining-procedure definition.
They have separate choices and separate defaults. - Pregnancy is categorical in Chapter 154. The declaration has no effect
during pregnancy; the adult cannot replace that rule with a viability choice. - Oral revocation does not require two witnesses. It becomes effective when
the attending professional is notified.
Common questions
May I use a notary instead of witnesses?
No. Section 154.03 requires two qualified witnesses and provides no notary
alternative.
Must both certifying clinicians be physicians?
No. Both must be health care professionals, one must be the attending
professional, and one must be a physician. The other may be another physician,
physician assistant, or qualifying advanced practice registered nurse.
Is county filing required?
No. Section 154.13 makes filing for safekeeping optional and says failure to
file creates no presumption about the adult's health care decisions.
Will Wisconsin honor a declaration signed in another state?
Yes, to the extent the document was valid where executed and is consistent with
Wisconsin law (§ 154.11(9)).
Statutes and sources
- Wis. Stat. §§ 154.01 and 154.02 — professional, procedure, condition,
feeding-tube, and qualified-patient definitions; future APRN-definition note.
Official Chapter 154 PDF
(accessed 2026-07-31). - Wis. Stat. § 154.03 — who may execute, signature and proxy signature,
witnesses, remote presence, optional form, treatment choices, comfort limits,
notice, and transfer direction. Official Chapter 154 PDF
(accessed 2026-07-31). - Wis. Stat. §§ 154.05 and 154.07 — revocation, record notation, immunity,
current wishes, provider transfer, and pregnancy. Official Chapter 154 PDF
(accessed 2026-07-31). - Wis. Stat. §§ 154.11 and 154.13 — copies, natural-dying boundary,
medical-record inclusion, interstate effect, and optional county filing.
Official Chapter 154 PDF
(accessed 2026-07-31).
Source links
Every statute quoted above, linked, with the date we checked it.
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