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All references made in accordance with North Carolina General Statutes Article 3, Section 32A-15 through 32A-25
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North Carolina advance health care directive consists of two documents.
These documents are: a Health Care Power of Attorney form (created in accordance with Section 32A-25, North Carolina General Statutes), and a Declaration for a Desire for a Natural Death (DDND), also called a Living Will.
The General Assembly recognizes as a matter of public policy the fundamental right of an individual to control the decisions relating to his or her medical care, and that this right may be exercised on behalf of the individual by an agent chosen by the individual.
NORTH CAROLINA POWER OF ATTORNEY FOR HEALTH CARE
You may appoint as your agent any competent person who is at least 18 years old and who is not providing paid health care to you. The person you appoint is called your health care agent.
Your North Carolina Health Care Power of attorney gives the person you designate your health care agent broad powers to make health care decisions, including mental health treatment decisions, for you.
Except to the extent that you express specific limitations or restrictions on the authority of your health care agent, this power includes the power to consent to your doctor not giving treatment or stopping treatment necessary to keep you alive, admit you to a facility, and administer certain treatments and medications. This power exists only as to those health care decisions for which you are unable to give informed consent.
You must sign your North Carolina Health Care Power of Attorney in the presence of two qualified witnesses, and it must be notarized.
This form does not impose a duty on your health care agent to exercise granted powers, but when a power is granted, your health care agent will have to use due care to act in your best interests and in accordance with this document. For mental health treatment decisions, your health care agent will act according to how the health care agent believes you would act if you were making the decision.
Because the powers granted by this document are broad and sweeping, you should discuss your wishes concerning life-sustaining procedures, mental health treatment, and other health care decisions with your health care agent.
You may name co-agents and successor agents under this North Carolina Health Care Power of Attorney, but you may not name a health care provider who may be directly or indirectly involved in rendering health care to you under this power.
You may also use Power of Attorney for Health Care to authorize your attorney in fact to make an anatomical gift upon your death.
If you wish to name a guardian of your person in the event a court decides that one should be appointed, you may, but are not required to, do so by providing the name of such guardian. You may, but are not required to, nominate as your guardian the same person named in this form as your agent.
If there is anything about this legal form that you do not understand, you should ask a lawyer to explain it to you.
NORTH CAROLINA DECLARATION FOR A DESIRE FOR A NATURAL DEATH, also called a LIVING WILL
In North Carolina statutory Living Will is called a Declaration for a Desire for a Natural Death. According to North Carolina law every person has a right to a natural death.
The following are important definitions you shall know before you start working on your Advance Health Care Directive.
Declarant means a person who has signed a declaration;
Extraordinary means is defined as any medical procedure or intervention which in the judgment of the attending physician would serve only to postpone artificially the moment of death by sustaining, restoring, or supplanting a vital function;
Physician means any person licensed to practice medicine under Article 1 of Chapter 90 of the laws of the State of North Carolina;
Persistent vegetative state is a medical condition whereby in the judgment of the attending physician the patient suffers from a sustained complete loss of self aware cognition and, without the use of extraordinary means or artificial nutrition or hydration, will succumb to death within a short period of time.
If a person has declared a desire that his life not be prolonged by extraordinary means or by artificial nutrition or hydration, these extraordinary means could be withheld when two conditions are met:
(1) It is determined by the attending physician that the declarant's present condition is:
a. Terminal and incurable; or
 b. Diagnosed as a persistent vegetative state; and
(2) There is confirmation of the declarant's present condition by a physician other than the attending physician.
The attending physician may rely upon a signed, witnessed, dated and proved declaration, or a copy of that declaration obtained from the Advance Health Care Directive Registry maintained by the Secretary of State pursuant to Article 21 of Chapter 130A of the General Statutes;
The attending physician may rely upon a signed, witnessed, dated and proved declaration, or a copy of that declaration obtained from the Advance Health Care Directive Registry maintained by the Secretary of State pursuant to Article 21 of Chapter 130A of the General Statutes;
A Living Will Declaration expresses a desire of the declarant that extraordinary means or artificial nutrition or hydration not be used to prolong his life if his condition is determined to be terminal and incurable, or if the declarant is diagnosed as being in a persistent vegetative state; and states that the declarant is aware that the declaration authorizes a physician to withhold or discontinue the extraordinary means or artificial nutrition or hydration;
A Declaration of a Desire for a Natural Death has to be signed by the declarant in the presence of two witnesses who believe the declarant to be of sound mind and who state that they:
- are not related within the third degree to the declarant or to the declarant's spouse,
- do not know or have a reasonable expectation that they would be entitled to any portion of the estate of the declarant upon his death under any will of the declarant or codicil thereto then existing or under the Intestate Succession Act as it then provides,
- are not the attending physician, or an employee of the attending physician, or an employee of a health facility in which the declarant is a patient, or an employee of a nursing home or any group care home in which the declarant resides, and
- do not have a claim against any portion of the estate of the declarant at the time of the declaration; and has to be proved before a clerk or assistant clerk of superior court, or a notary public.
The living will declaration may be revoked by the declarant, in any manner by which he is able to communicate his intent to revoke, without regard to his mental or physical condition. Such revocation shall become effective only upon communication to the attending physician by the declarant or by an individual acting on behalf of the declarant.
No person shall be required to sign a declaration as a condition for becoming insured under any insurance contract or for receiving any medical treatment.
The withholding or discontinuance of extraordinary means and/or the withholding or discontinuance of either artificial nutrition or hydration, or both in accordance with this section shall not be considered the cause of death for any civil or criminal purposes nor shall it be considered unprofessional conduct. Any person, institution or facility against whom criminal or civil liability is asserted because of conduct in compliance with this section may interpose this section as a defense.
Any certificate in the form provided prior to July 1, 1979, shall continue to be valid.
The determination that a person is dead shall be made by a physician licensed to practice medicine applying ordinary and accepted standards of medical practice.
Brain death, defined as irreversible cessation of total brain function, may be used as a sole basis for the determination that a person has died, particularly when brain death occurs in the presence of artificially maintained respiratory and circulatory functions. This specific recognition of brain death as a criterion of death of the person shall not preclude the use of other medically recognized criteria for determining whether and when a person has died.
Registration. You may register your Advance Health Care Directive with the Secretary of State, but you are not required by law to do so.
If there is anything about these legal forms that you do not understand, you should ask a lawyer to explain it to you.
You should talk with your family, your health-care professional, your attorney, and any agent or attorney-in-fact that you appoint
about your health care decision to make one or more advance directives. If they know what health care you want, they will find it easier
to follow your wishes. If you cancel or change an advance health care directive in the future, remember to tell these same people about
the change or cancellation.
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To better understand the health care and pecuniary related issues our legal articles, frequently asked questions, facts and other law related information may be of interest to you.
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