Mississippi Advance Health Care Directive Form


Mississippi advance health care directive is completed by a principal to designate an agent to carry out their health-related wishes when they are no longer able. This advance health care directive consists of three (3) parts: 1) power of attorney for health care, 2) instructions for health care and 3) primary physician (optional). In the first section, the principal appoints an agent and alternate agent(s) to make health decisions on their behalf if they become incapacitated. The second part includes the principal’s preferences for life-sustaining treatment, pain relief, or any other type of care. Completing the third section allows them to choose a primary physician they feel comfortable with and know well.

The principal may or may not wish to prolong their life if death is imminent or they are comatose. Using this form, they can opt for treatment that will keep them comfortable until they become healthy or pass away. They can also include whether or not they prefer artificial nutrition and hydration. In unmentioned circumstances, the agent must use their best judgment to make medical choices for the principal.

Laws: §§ 41-41-201 – 41-41-229

Signing requirements (§ 41-41-205(2)): Principal must sign in front of a Notary Public or two (2) witnesses.

Additional considerations: An adult or emancipated minor can give oral or written instructions on how the principal should receive care if an advance health care directive does not already exist (§ 41-41-205). The assigned agent is often someone who is related by blood, marriage, or adoption. They cannot own, operate, or work at the healthcare facility where the principal is undergoing care.

The principal should communicate their health care wishes in writing as opposed to orally stating them. Having the instructions in the form prevents miscommunication on how the agent should carry out the principal’s wishes. The agent must follow through with the directions as written in the document.