![North Carolina Advance Directive Form [PDF]](/_next/image?url=%2Fimages%2Fdocuments%2Fadvance-directive-general.png&w=3840&q=75)
An advance directive in North Carolina, often referred to as an advance directive for a natural death or “living will,” outlines an individual’s preferences regarding medical issues they may need to undergo.
An advance directive form is used when a person cannot communicate their medical wishes, such as decisions about life-support treatments or other critical interventions, due to incapacitation.
As a key part of advance care planning, this document should include a durable power of attorney for health care (medical power of attorney). This form allows the individual in question to appoint a trusted person to make medical decisions on their behalf.
Signing Requirements for the North Carolina Advance Health Care Directive
As outlined in North Carolina General Statutes in Section 90-321, the signing requirements for a health care advance directive include the following:
Signing Requirements for North Carolina
The individual (declarant) must sign the directive.
The directive must be signed in the presence of two qualified witnesses.
The document must be proved before a notary public or a clerk of the superior court. The notary or clerk will certify that the directive meets the statutory requirements.
As for the qualified witnesses for a health care advance directive, they should meet the following criteria:
Be at least 18 years old
Not be related to the declarant within the third degree
Not have a claim to the declarant's estate
Not be the attending physician or healthcare facility employees where the declarant is a patient
North Carolina Advance Health Care Directive Revocation & Changing
A North Carolina advance directive becomes effective when the declarant is deemed unable to make or communicate decisions about their medical care. This typically happens if they are in a coma, have advanced dementia, or are otherwise incapacitated.
According to Section 90-321(e), the declarant can revoke the advance directive for health care at any time, regardless of their mental or physical condition. They can do so in writing or through any method that clearly shows their intent to revoke the directive.
On the other hand, a health care agent can also revoke an advance directive if the health care power of attorney explicitly grants them that authority.
Additional Legal Considerations for North Carolina Advance Health Care Directive
According to Section 90-321(b), if the declarant clearly states that they don’t want their life to be extended by artificial means, this wish will be followed under specific conditions:
The primary doctor determines that the declarant’s current health condition matches the one specified in their directive—e.g., being in a coma.
Another independent doctor must confirm the diagnosis or condition.
As Section 90-321(k) specifies, when the physician feels that following the health care advance directive would violate their personal beliefs or the ethical policy of the facility where the patient is hospitalized, they can decline to honor it. In that case, they must help the patient find a replacement physician who will honor the directive or assist in transferring them to a facility that will comply.
North Carolina allows the declarant to register their advance directive for a $10 fee by submitting the completed Registration Form to:
North Carolina Secretary of State Advance Health Care Directive Registry
P.O. Box 29622 Raleigh, NC
Once registered, the declarant will receive a Registry Card with a unique file number and password, allowing their secure online access to their directive anytime.
How to Choose a Health Care Agent in North Carolina
To choose your North Carolina health care proxy (agent), select someone you trust who is responsible, reliable, and able to make decisions under pressure. Before you make everything official, confirm their willingness to take on the role, understanding of your values, and ability to act in your best interest.
They can be a family member, friend, or anyone you trust but cannot be your doctor or a paid health care provider unless they are related to you. Legally, they must be over 18 and of sound mind.
What Happens if You Don’t Have an Advance Directive in North Carolina?
If you do not have an advance directive in North Carolina, medical decisions will be made by your family or close friends. They will determine your medical care based on doctors’ recommendations and what they believe is best for you.
However, without an advance directive, your specific wishes regarding treatment may not be honored, as they are not formally documented anywhere. The absence of this document may, in return, lead to decisions that may not align with your personal preferences.