This information will help you understand a federal law called the Patient Self-Determination Act. All hospitals and other health care institutions must inform patients of their right to agree to or refuse medical treatment. In addition, patients must be asked if they have an advance directive.
If you are 18 or older and mentally competent, you have the right to make decisions about your medical treatment. If you want to control decisions about your health care, even if you become unable to make or to express them yourself, you will need an advance directive.
An advance directive is a form you sign now to direct your future health care if you cannot speak for yourself in the future. "Advance" means you tell your wishes ahead of time before you are too sick to talk. "Directives" means you direct your future health care. In this form, you state your wishes about what happens to you when you are dying or are in a coma and unable to speak. You decide if you want artificial treatments, which may keep you alive for a very long time.
What is an Advance Directive?
An advance directive is a set of directions you give about the health care that you want if you ever lose the ability to make decisions for yourself. North Carolina has two ways for you to make a formal advance directive. One way is called a living will. The other way is called health care power of attorney.
Do I Have to Have an Advance Directive? What Happens if I Don't?
Making a living will or a health care power of attorney is your choice. If you become unable to make your own decisions, and you have no living will or health care agent (a person named to make medical decisions for you), your doctor or health care provider will consult with someone close to you about your care.
In North Carolina, a living will is a document that tells others that you want to die a natural death if you are terminally and incurably ill or in a persistent vegetative state from which you will not recover. In a living will, you can direct your doctor not to use heroic treatments that would delay your dying (using a respirator or ventilator, for example) or to stop such treatments if they have been started. You can also direct your doctor not to begin or to stop giving you food and water through a tube, called artificial nutrition or hydration.
Health Care Power of Attorney
In North Carolina, you can name a person to make medical care decisions for you if you later become unable to decide for yourself. This person is called your health care agent. In the legal document, you name who you want your agent to be. You can also state what medical treatments you would want and what you would not want. Your agent then knows what choices you would make.
You should choose someone you trust as your health care agent and discuss your wishes with him or her before you put them in writing.
Advance Directive FAQ
Answers to other common questions about advance directives.
How do I Make an Advance Directive?
You must follow several rules when you make a living will or a health care power of attorney. These rules are to protect you and ensure that your wishes are clear to the doctor or other provider who may be asked to carry them out. Both a living will and health care power of attorney must be written and signed by you while you are still able to understand your condition and treatment choices and to make those choices known. Both types of advance directives must be witnessed by two qualified people and be notarized.
Are There Forms I can Use to Make an Advance Directive?
There is a living will form and a health care power of attorney form that you can use. These forms meet all of the rules for a formal advance directive. Using the special forms is the best way to make sure that your wishes are carried out. In North Carolina, an advance directive takes two forms: a living will and a health care power of attorney. These forms can be downloaded here. Please do not sign these forms unless a notary is present.
When Does an Advance Directive Take Effect?
A living will goes into effect when you are going to die soon and cannot be cured, or when you are in a persistent vegetative state. The powers granted by your health care power of attorney go into effect when your doctor states in writing that you are not able to make decisions about your treatment.
What Happens if I Change My Mind?
You can cancel your living will either by destroying all the copies of it or by informing your doctor that you want to cancel it. You can change your health care power of attorney by signing another one or by telling your doctor and each health care agent you named of the change.
Whom 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 doctor or health care provider can answer any medical questions you might have. A lawyer can answer questions about legal issues. Some people also discuss the decision with clergy or other trusted advisers.
What if I Have an Advance Directive from Another State?
An advance directive from another state may not meet all of North Carolina's rules. To be sure of this, you may want to make an advance directive in North Carolina or have your lawyer review the advance directive from the other state.
Where can I Get More Information?
Your health care provider can tell you how to get more information about advance directives by contacting the social worker on the second floor of the South Wing, ext. 7200.
Hugh Chatham Memorial Hospital honors advance directives to the extent authorized by North Carolina law.
This page has been developed by the North Carolina Division of Medical Assistance in cooperation with the Department of Human Resources Advisory Panel on Advance Directives.
For additional information, contact:
- Carolinas Center for Hospice and End of Life Care 1-800-882-8839 or visit Carolinas End of Life Care.
- To register your advance directives online, contact Advance Health Care Directive Registry, (919) 807-2167, or www.secretary.state.nc.us/ahcdr/.
Hugh Chatham Memorial Hospital
180 Parkwood Drive
Elkin, NC 28621