Other forms that you may want to be aware of include: Authorization to Consent to Health Care for a Minor, Organ Donor Card, Portable Do Not Resuscitate (DNR) Orders, and Medical Orders for Scope of Treatment (MOST).
¨ An authorization to consent to health care for a minor is a legal document that allows parents with sole or joint legal custody of a minor (under 18) to authorize another adult to make certain health care decisions for their child or children in their absence. For more information, go to: www.ncleg.net/Enacted Legislation/Statutes/HTML/BySection/Chapter_32A/GS_32A-34.html.
¨ An Organ Donor Card is a document that allows you to donate your organs. You can become an organ donor by expressing your desire to donate in your will, by authorizing the NC Division of Motor Vehicles to put an organ donor symbol on your driver’s license or identification card, by completing an organ donor card or other document, or by authorizing that a statement or symbol be included on the NC Organ Donor Registry.
You also may authorize an agent to make an anatomical gift of organs under a health care power of attorney. To make sure your wishes are honored, you should discuss organ donation with your family, friends, and health care providers so they know and can carry out your wishes. You can get an
organ donor card from the North Carolina Department of the Secretary of State Advance Health Care Directive Registry at: www.secretary. state.nc.us/ahcdr.
¨ A Portable Do Not Resuscitate (DNR) Order is a medical o
rder that can be followed by emergency medical responders or other health care
providers that tells them not to attempt cardiopulmonary resuscitation (CPR) if your heart and breathing stop (cardiopulmonary arrest). Because it is portable, it can be followed in different settings (for example, in your home, in a nursing home, or in a hospital). Since a Portable DNR Order is a
physician or medical order it must be signed by your physician (in NC, physician assistants and nurse practitioners also may issue these orders). It is effective when it is completed and signed by your physician (or physician assistant or nurse practitioner). It can be canceled by destroying or writing
“void” on the original form. Portable DNR Orders must be obtained from your physician. For more information, be sure to talk to your physician or other health care provider.
¨ A Medical Order for Scope of Treatment, called a MOST form, like a Portable DNR Order, is a medical order that can be followed in different settings such as in the home, nursing home, hospital, etc. A MOST form contains instructions for CPR and also addresses other end-of-life treatments that you may or may not want to receive. For example, a MOST can tell emergency medical responders and other health care providers what level of treatment you would like to receive, whether you would like to receive antibiotics, and artificial nutrition and hydration through tubes. While a MOST is a medical order that must be signed by your physician (or physician assistant or nurse practitioner), it also must be signed by you or, if you are not able to make or communicate your health care decisions, by someone who is legally recognized to speak for you. A MOST can be canceled by destroying the original form or indicating on the form that it is void. A MOST form must be obtained from your physician. For more information, be sure to talk to your physician or other health care provider. Information in this document was derived from www.ncdhhs.gov/dma