All fifty states have some type of advanced directive in force. The most popular form is the living will, which allows patients to specify in advance the conditions under which they would want treatment continued or withdrawn if they became incapacitated.

Many states are now enacting laws establishing durable power of attorney for health decisions, so patients can pre-authorize who can make medical decisions on their behalf. A number of states are passing medical surrogate laws, which specify who can make decisions for an incompetent patient who leaves no advance directive.

In many cases, state legislative action has been triggered by public reaction to high profile cases like the 1990 Supreme Court decision in the case of Nancy Cruzan.