Who decides about my medical care or
treatment?
If you are 18 or older and are able to make and communicate health care decisions, you have the right to make decisions about your medical and mental health treatment. You should talk to your physician or other health care or mental health provider about any treatment or procedure so that you understand what will be done and why. You have the right to say yes or no to treatments recommended by your physician or mental health provider. If you want to control decisions about your medical and mental health care even if you become unable to make decisions or to express them yourself, you should be sure to tell your physician or mental health provider and your family and friends what you want, but you also should have an advance directive.
Advance Directive
What is an advance directive?
An advance directive is a set of directions you give about the medical and mental health care you want if you ever lose the ability to make decisions for yourself. North Carolina has three ways for you to make a
formal advance directive. These include: living wills; health care powers of attorney; and advance instructions for mental health treatment. Do I have to have an advance directive and what happens if I don’t? Making an advance directive is your choice. If you become unable to make your own decisions, and you have no advance directive, your physician or mental health care provider will consult with someone
close to you about your care. Discussing your wishes for medical and mental health treatment with your family and friends now is strongly encouraged, as this will help ensure that you get the level of treatment
you want when you can no longer tell your physician or other health care or mental health providers what you want.
Living Will
What is a living will?
In North Carolina, a living will is a legal document that tells others that you want to die a natural death if you: ¨ become incurably sick with an irreversible condition that will result in your death within a short period of time; ¨ are unconscious and your physician determines that it is highly unlikely you will regain consciousness; or ¨ have advanced dementia or a similar condition which results in a substantial cognitive loss and it is highly unlikely the condition can be reversed. In a living will, you can direct your physician not to use certain life-prolonging treatments such as a breathing machine (“respirator” or “ventilator”), or to stop giving you food and water through a tube (“artificial nutrition or hydration” through feeding tubes and IVs). A living will goes into effect only when your physician and one other physician determine that you meet one of the conditions specified in the living will. Discussing your wishes with family, friends, and your physician now is strongly encouraged so that they can help make sure that you get the level of care you want at the end of your life.
Health Care Power of Attorney
What is a health care power of attorney?
A health care power of attorney is a legal document in which you can name a person(s) as your health care agent(s) to make medical and mental health decisions for you if you become unable to decide for yourself. You can say what medical or mental health treatments you would want and not want. You should choose an adult you trust to be your health care agent. Discuss your wishes with that person(s) before you put them in writing. Again, it is always helpful to discuss your wishes with your family, friends, and your physician or eligible psychologist. A health care power of attorney will go into effect when a physician states in writing that you are not able to make or to communicate your health care choices. If, due to moral or religious beliefs, you do not want a physician to make this determination, the law provides a process for a non-physician to do it. Advance Instruction for Mental Health Treatment
What is an advance instruction for mental health treatment?
An advance instruction for mental health treatment is a legal document that tells physicians and mental health providers what mental health treatments you would want and what treatments you would not want,
if you later become unable to decide for yourself. You also can name a person to make your mental health decisions at that time. Your advance instruction for mental health treatment can be a separate document or combined with a health care power of attorney or a general power of attorney. An advance instruction for mental health may be followed by a physician or mental health provider when your physician or an eligible psychologist determines in writing that you are no longer able to make or communicate mental health care decisions.
Other Questions
How do I make an advance directive?
You must follow several rules when you make a formal living will, health care power of attorney or an advance instruction for mental health treatment. These rules are to protect you and ensure that your wishes are clear to the physician or mental health provider who may be asked to carry them out. A living will, a health care power of attorney and an advance instruction for mental health treatment must be: (1) written; (2) signed by you while you are still able to make and communicate health care decisions; (3) witnessed by two qualified adults; and (4) notarized.
Who is a qualified witness?
A qualified witness is a competent adult who sees you sign, is not
a relative, and will not inherit anything from you upon your death.
The witness cannot be your physician, a licensed employee of your
physician or mental health providers, or any paid employee of a health
care facility where you live or that is treating you.
Are there forms I can use to make an advance directive?
Yes. Forms for living wills, health care powers of attorney, and advance
instructions for mental health treatment may be obtained from the
North Carolina Secretary of State website, at: www.secretary.state.
nc.us/ahcdr. These forms meet all the rules for a formal advance
directive. For more information, visit the website, or call 919-807-2167,
or write to:
Advance Health Care Directive Registry
Department of the Secretary of State
PO Box 29622
Raleigh, NC 27626-0622
What happens if I change my mind?
¨ You can cancel your living will anytime by communicating your intent to cancel it in any way. You should inform your physician and those closest to you about your decision. It is also a good idea to destroy copies of it. ¨ You can cancel or change your health care power of attorney while you are able to make and communicate your decisions. You can do this by executing another one and telling your physician and each health care agent you named of your intent to cancel the previous one and make a new one, or by communicating your intent to cancel it to the named health care agents and the attending physician or eligible psychologist. ¨ You can cancel your advance instruction for mental health treatment while you are able to make and communicate your decisions by telling your physician or mental health provider that
you want to cancel it.
Who should I talk to about an advance directive?
You should talk to those closest to you about an advance directive and your feelings about the health care you would like to receive. Your physician or health care provider can answer medical questions. A lawyer can answer questions about the law. A trusted advisor or clergy member might be able to help with more personal questions.
Where should I keep my advance directive?
Keep a copy in a safe place where your family members can get it. Give copies to your family, your physician or mental health providers, your health care agent(s), and any family members or close friends who might be asked about your care should you become unable to make decisions. Always remember to take a copy of your Advance Directive with you for hospital admissions, emergency room visits, clinic visits for cardiac procedures, etc. so it can be put into your chart. Also, consider registering your advance directives with the North Carolina Advance Health Care Directive Registry: www.secretary.state.nc.us/ahcdr.
What if I have an advance directive from another state?
A living will or health care power of attorney created outside North Carolina is valid in North Carolina if it appears to have been executed in accordance with the applicable requirements of the place where it was
created or of this State.
Where can I get more information?
Contact your health care provider or attorney, or visit the North Carolina Department of the Secretary of State Advance Health Care Directive Registry website at: www.secretary.state.nc.us/ahcdr.