Advance Care Planning
An advance directive allows you to express your wishes for future healthcare and to guide decisions about that care. It does not address financial decisions. Although there is no legal requirement for you to have an advance directive, completing one may help you to receive the healthcare you desire.
If you are 18 years old or older and are able to make and communicate healthcare decisions, you may have an active advance directive.
Healthcare Power of Attorney
What is a healthcare power of attorney?
A healthcare power of attorney is a legal document in which you name another person, called a "healthcare agent," to make healthcare decisions for you when you are not able to make those decisions for yourself.
Who can be a healthcare agent?
Any competent person who is at least 18 years old and who is not your paid healthcare provider may be your healthcare agent.
How should you choose your healthcare agent?
You should choose your healthcare agent very carefully, because that person will have broad authority to make decisions about your healthcare. A good healthcare agent is someone who knows you well, is available to represent you when needed, and is willing to honor your wishes. It is very important to talk with your healthcare agent about your goals and wishes for your future healthcare, so that he or she will know what care you want.
What decisions can your healthcare agent make?
Unless you limit the power of your healthcare agent, your healthcare agent can make all healthcare decisions for you, including:
- Starting or stopping life-prolonging measures.
- Decisions about mental health treatment.
- Choosing your doctors and facilities.
- Reviewing and sharing your medical information.
- Autopsies and disposition of your body after death.
Can your healthcare agent donate your organs and tissues after your death?
Yes, if you choose to give your healthcare agent this power on your directive.
When will this healthcare power of attorney be effective?
It will become effective if your doctor determines that you have lost the ability to make your own healthcare decisions.
How can you revoke this healthcare power of attorney?
If you are competent, you may revoke this healthcare power of attorney in any way that makes clear your desire to revoke it. For example, you may destroy this document, write "void" across this document, tell your doctor that you are revoking the document, or complete a new healthcare power of attorney.
Who makes healthcare decisions for me if I don't name a healthcare agent and I am not able to make my own decisions?
If you do not have a healthcare agent, North Carolina law requires healthcare providers to look to the following individuals, in the order listed below: legal guardian; an attorney-in-fact under a general power of attorney (POA) if that POA includes the right to make healthcare decisions; a husband or wife; a majority of your parents and adult children; a majority of your adult brothers and sisters; or an individual who has an established relationship with you, who is acting in good faith and who can convey your wishes. If there is no one, the law allows your doctor to make decisions for you as long as another doctor agrees with those decisions.
What is a living will?
In North Carolina, a living will lets you state your desire not to receive life-prolonging measures in any or all of the following situations:
- You have a condition that is incurable that will result in your death within a short period of time.
- You are unconscious, and your doctors are confident that you cannot regain consciousness.
- You have advanced dementia or other substantial and irreversible loss of mental function.
What are life-prolonging measures?
Life-prolonging measures are medical treatments that would only serve to postpone death, including breathing machines, kidney dialysis, antibiotics, tube feeding (artificial nutrition and hydration), and similar forms of treatment.
Can life-prolonging measures be withheld or stopped without a living will?
Yes, in certain circumstances. If you are able to express your wishes, you may refuse life-prolonging measures. If you are not able to express your wishes, then permission must be obtained from those individuals who are making decisions on your behalf.
What if you want to receive tube feeding (artificial nutrition and hydration)?
You may express your wish to receive tube feeding in all circumstances.
How can you revoke this living will?
You may revoke this living will by clearly stating or writing in any clear manner that you wish to do so. For example, you may destroy the document, write "void" across the document, tell your doctor that you are revoking the document, or complete a new living will.
This information is from the Advance Directive for North Carolina document. To read the full text and access the form, see the pdf in the right-hand column.
Resources for Advance Care Planning
Three simple resources to guide you as you think about the issues related to Advance Care Planning:
Additional helpful resources that are more comprehensive in approach to Advance Care Planning:
- North Carolina Medical Society brochure: Medical Care Decisions and Advance Directives: What You Should Know
- Medical Society End-of-Life Resources
- North Carolina Bar Association: A Gift to Your Family
- Medical Orders for Scope of Treatment Sample Form (MOST)
Community resources to assist with advance care planning: