Healthcare Proxy vs Living Will in Rhode Island: Key Differences
Healthcare Proxy vs Living Will in Rhode Island: Key Differences
Rhode Island residents sometimes assume a Living Will and a healthcare proxy are the same thing. They are not — and using only one leaves a significant gap in your planning.
What Each Document Does
The Durable Power of Attorney for Healthcare (DPOAH) is Rhode Island's version of a healthcare proxy. Authorized under R.I. Gen. Laws § 23-4.10-2, it lets you designate a healthcare agent (attorney-in-fact) who can make any medical decision on your behalf if you become incapacitated. This covers everything from authorizing surgery after a car accident to deciding whether to continue dialysis during a long illness.
The DPOAH activates whenever your attending physician formally determines you lack decision-making capacity — it does not require a terminal diagnosis.
The Living Will (Declaration) is governed by R.I. Gen. Laws § 23-4.11-3 and is much narrower. It is a written instruction to physicians, not a person. It only becomes operative when three conditions align: your doctor diagnoses a terminal condition, you lack capacity to make treatment decisions, and the document has been communicated to your attending physician.
The Living Will tells doctors what to do. The DPOAH tells them who to listen to.
Why You Need Both
A Living Will alone leaves you unprotected in non-terminal situations. If you have a severe stroke or traumatic brain injury but are not terminally ill, the Living Will has no legal effect. Without a DPOAH, no one in your family has automatic authority to direct your care — Rhode Island is one of only four states without a default family surrogate law.
A DPOAH alone means your agent makes every decision without written guidance about your specific preferences. If your agent doesn't know how you feel about tube feeding, ventilators, or experimental treatments, they're guessing under pressure.
Together, the two documents create a complete framework: the Living Will documents your specific wishes, and the DPOAH empowers someone you trust to handle everything the Living Will doesn't cover.
The Signing Rules Are Different
This catches many Rhode Islanders off guard:
| Requirement | Living Will | DPOAH |
|---|---|---|
| Witnesses required | Two (mandatory) | Two OR one notary |
| Witness relationship | Must be unrelated by blood or marriage | At least one must be unrelated |
| Healthcare worker witnesses | Not specifically excluded | Explicitly disqualified |
| Notary as alternative | Not permitted | Permitted |
The Living Will is stricter — you cannot substitute a notary for witnesses. Both documents require that witnesses have no financial interest in your estate.
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One Document Rhode Island Calls Something Different
You may hear the terms "healthcare proxy," "medical power of attorney," and "durable power of attorney for healthcare" used interchangeably in Rhode Island. They all refer to the same statutory instrument — the DPOAH under § 23-4.10-2. Rhode Island does not have a separate "healthcare proxy" form; the DPOAH is the healthcare proxy.
What About MOLST?
A third document — Medical Orders for Life-Sustaining Treatment (MOLST) — is different from both the Living Will and DPOAH. The MOLST is a medical order completed by a physician, not a legal planning document. It is designed for patients already diagnosed with terminal illness and produces immediate, actionable clinical orders on bright pink cardstock.
Your advance directive (DPOAH + Living Will) should be completed first. A MOLST comes later, if needed, in consultation with your doctor.
Common Misconceptions
"My spouse can make my medical decisions automatically." Not in Rhode Island. Without a DPOAH, your spouse has no more legal authority than a stranger. This is one of the most dangerous misconceptions in the state — and it's the direct result of Rhode Island lacking a default surrogate law.
"A Living Will covers everything." It only applies when you are terminally ill and incapacitated. A non-terminal stroke, a car accident, or early dementia would leave you without any legally authorized decision-maker if you only have a Living Will.
"I'm too young to need this." Incapacity can happen at any age — a car accident, an anesthesia complication during routine surgery, a sudden medical event. The legal consequences of not having a DPOAH are the same whether you are 25 or 75.
Bottom Line
Complete both documents. The DPOAH designates who speaks for you. The Living Will documents what you want. Together, they create a complete healthcare planning framework that keeps your family out of probate court and your medical decisions in trusted hands.
The Rhode Island Advance Directive & Living Will Kit includes both the DPOAH and Living Will with Rhode Island-specific witness checklists so you can complete everything correctly the first time.
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