Maryland's Health Care Decisions Act (Maryland Code, Health-General § 5-601 et seq.) governs advance directives and healthcare agent designations. Without a properly executed Maryland advance directive, hospitals and care facilities cannot legally act on the wishes of your chosen healthcare agent.
Many Maryland clients also receive care across the DC-Maryland-Virginia region. A directive that works only in Maryland is not enough for a mobile professional who may receive emergency care at a DC hospital on the way home from work.
Without a Maryland Advance Directive
- ✕Medical decisions default to next of kin in Maryland's legal priority order — which may not include your partner or closest friend
- ✕Family members may disagree — and the conflict plays out while you are in the ICU
- ✕Court guardianship may be required — time-consuming and expensive
Your Maryland Healthcare Documents
Two Documents Maryland Residents Need
Maryland Combined Advance Directive
Agent + instructions in one document
Maryland's unified document names your healthcare agent and expresses your wishes about life-sustaining treatment, resuscitation, and end-of-life care. Must be signed before two witnesses — not the agent, not a healthcare provider.
MOLST
For seriously ill patients
A physician's medical order — not just a directive — that travels with you between Maryland facilities. Appropriate for patients with serious illness who want their preferences to be immediately actionable. We coordinate with your physicians.
Cross-State Note — Maryland + DC + Virginia
Maryland's advance directive is recognized in other states under most interstate reciprocity provisions. For clients who regularly receive care in DC or Virginia, we include cross-jurisdictional recognition language and advise on distribution to facilities in all three jurisdictions.
The Path Forward
Four Steps to a Maryland Advance Directive
1
Consultation — Name Your Agent and Clarify Your Values
We discuss your values, your concerns about end-of-life care, and who you trust to make medical decisions. We help you think through scenarios carefully — so your document reflects real decisions, not vague preferences.
2
Drafting — Maryland Combined Advance Directive
We draft the Maryland combined advance directive — designating your healthcare agent and expressing your preferences for life-sustaining treatment, resuscitation, artificial nutrition, and pain management.
3
Execution — Two Qualified Witnesses
Two witnesses sign your advance directive. They cannot be your healthcare agent, cannot be a healthcare provider, and cannot have a financial interest in your estate. We advise on witness selection and coordinate execution.
4
Distribution — Your Doctor, Agent, and Maryland Facilities
We advise you to provide copies to your primary physician, your agent, and any Maryland facility where you regularly receive care — including Johns Hopkins, University of Maryland Medical Center, Holy Cross, and Suburban Hospital.
Your Attorney
Estate Planning Counsel
SV
Sunil Varghese
Georgetown Law · Partner, Estate Planning
New York Bar DC Bar Maryland Bar
Sunil drafts Maryland advance directives from our Bethesda office that are accepted at Johns Hopkins, University of Maryland Medical Center, Holy Cross, and Suburban Hospital. He takes time to understand your values before drafting — ensuring the document reflects your real wishes, not a generic form.
View Full Profile → Common Questions About Maryland Healthcare Directives
What is the Maryland combined advance directive?
Maryland's combined advance directive does two things in one document: (1) designates a healthcare agent, and (2) expresses your wishes about life-sustaining procedures. It must be signed before two witnesses — who cannot be the healthcare agent or a healthcare provider.
What is a MOLST in Maryland?
For seriously ill patients, a MOLST (Medical Orders for Life-Sustaining Treatment) is a physician's medical order — not just a directive — that travels with you between facilities. We coordinate with your physicians on when and how a MOLST is appropriate alongside your advance directive.
Does my Maryland advance directive work in DC or Virginia?
Maryland's advance directive is recognized in other states under most interstate reciprocity provisions. We review your situation and, where needed, prepare documents valid in multiple jurisdictions. For clients who regularly receive care in DC, we include cross-jurisdictional language in DC documents as well.
What happens without an advance directive in Maryland?
Without an advance directive, medical decisions are made by a court-appointed guardian or by next of kin — in a legal order that may exclude your partner, close friend, or the person who knows you best. The result is often court involvement, family conflict, and treatment decisions that don't reflect your values.
Ready to protect your medical wishes in Maryland? Schedule your Maryland healthcare directives consultation or browse our estate planning FAQ.
Estate Planning Notice: Estate planning laws vary by state and change frequently. This website provides general information only and does not constitute legal advice. A consultation with an attorney licensed in your state is required for legal advice tailored to your situation. Wills and trusts must be executed in accordance with state law or they may be invalid. The information on this site does not create an attorney-client relationship.
