Consumers
Topics in this section:
- Medical Care Decisions and Advance Directives
- How Advance Directives Work in North Carolina Facilities
Medical Care Decisions and Advance Directives:
What You Should Know
What are My Rights?
Who decides about my medical care or treatment?
If you are 18 or older and mentally competent, you have the right to make decisions about your medical
treatment. You should talk to your doctor or other health care 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
doctor. 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."
What is an advance directive?
An advance directive is a set of directions you give about the 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. One way is called a "living will"; another is called a "health care power of attorney";
and another is called an "advance instruction for mental health treatment."
Do I have to have an advance directive; what happens if I don't?
Making a living will, a health care power of attorney, or an advance instruction for mental health
treatment is your choice. If you become unable to make your own decisions, and you have no living
will or a person named to make medical decisions for you (health care agent), your doctor or health
care provider will consult with someone close to you about your care. If you have no advance
instruction for mental health treatment, or person named to make mental health treatment decisions
for you (attorney-in-fact), then your doctor or mental health treatment provider will consult with
someone close to you about your care.
Living Will
What is a living will?
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 sick 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, for example by using a breathing machine (respirator or ventilator), 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 (artificial nutrition or hydration).
Health Care Power of Attorney
What is a 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 yourself. This person is called your health care agent. In the legal document you
name who you want your agent to be. You can say what medical treatments you would want and what you
would not want. Your health care agent then knows what choices you would make.
How should I choose a health care agent?
You should choose an adult you trust and discuss your wishes with the person before you put them in writing.
Advance Instruction for Mental Health Treatment
What is an advance instruction for mental health treatment?
In North Carolina, an advance instruction for mental health treatment is a legal document that tells doctors
and health care providers what mental health treatments you would want or not want, if you become unable
to decide yourself. With this document, you can also choose someone to make these decisions for you when
you are unable to make them. This person is called your attorney-in-fact. This person does not have to be
a lawyer.
How should I choose an attorney-in-fact for mental health treatment?
You should choose an adult you trust and discuss your wishes with that person. This person needs to sign
the advance instruction for mental health treatment, agreeing to make these decisions for you.
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 doctor or other 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 written and signed
by you while you are still able to understand your condition and treatment choices and to make those choices
known. All three types of advance directives must be witnessed by two qualified people. The living will
and the health care power of attorney also must be notarized.
Are there forms I can use to make an advance directive?
Yes. There is a living will form, a health care power of attorney form, and an advance instruction
for mental health treatment form that you can use. These forms meet all of the rules for a formal
advance directive. Using the special form is the best way to make sure that your wishes are carried out.
When does an advance directive go into 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 or to make known your health care choices.
When you make a health care power of attorney, you can name the doctor you would want to make this decision.
An advance instruction for mental health treatment goes into effect when it is given to your doctor.
The doctor will follow the instructions you have put in the document, except in certain situations,
after the doctor determines that you are not able to make and to make known your choices about mental
health treatment. After a doctor determines this, if you have an attorney-in-fact, that person may make
treatment decisions for you. An advance instruction for mental health treatment expires after two years.
What happens if I change my mind?
You can cancel your living will anytime by informing your doctor that you want to cancel it and
destroying all copies of it. You can change your health care power of attorney while you are able
to make and make known your decisions, by signing another one and telling your doctor and each health care
agent you named of the change. You can cancel your advance instruction for mental health treatment while
you are able to make and make known your decisions, by telling your doctor or other provider that you
want to cancel it.
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 medical questions.
A lawyer can answer questions about the law. Some people also discuss the decision with clergy or other
trusted advisors.
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
doctor or other health care provider, your health care agent, your attorney-in-fact and any close friends
who might be asked about your care should you become unable to make decisions.
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 about this,
you may want to make an advance directive in North Carolina, too. You can also 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:
This information on this page was developed by the North Carolina Division of Medical Assistance in cooperation
with the Department of Human Resources Advisory Panel on Advance Directives 1991. Revised 1998.
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