South Carolina Advance Directive Form [PDF]

An advance directive in South Carolina is a vital part of advance care planning, as it allows individuals (principals) to plan their future medical care should they become unable to communicate their wishes.

This document includes a living will, where principals can specify preferences for end-of-life treatments like artificial life support, palliative care, or a do-not-resuscitate (DNR) order. Additionally, it can include a durable power of attorney for health care (also called a medical power of attorney) and appoint a trusted person to make medical decisions on their behalf.

By doing so, principals ensure their healthcare decisions align with their values and provide clear guidance to loved ones and medical providers.

Signing Requirements for South Carolina Advance Health Care Directive

In South Carolina, signing health care advance directive, including a health care power of attorney and a living will (declaration), must comply with specific legal formalities under Sections 62-5-503 and 44-77-40 of the South Carolina Code of Laws. These formalities are as follows:

Signing Requirements for South Carolina

The document must be dated and signed by the principal or another person in the principal's presence and direction.

Two witnesses must sign the document, and if the principal resides in a hospital or nursing care facility, one witness must be an ombudsman designated by the State Ombudsman's Office.
A notary is required to administer oaths for the signing of the declaration, and at least one witness must swear to an affidavit affirming the signing in the presence of the principal and the notary.

The witnesses must meet the following qualifications:

Not be related to the principal by blood, marriage, or adoption, including as a spouse, lineal ancestor, descendant of the principal's parent, or the spouse of any such relative.
Not be financially responsible for the principal's medical care.
Not be entitled to any portion of the principal's estate under a will, as an heir, or as a life insurance policy beneficiary.
Not be appointed as a health care agent or successor health care agent in the health care power of attorney.
Not be the attending physician or an employee of the attending physician.
No more than one witness is an employee of a healthcare facility where the principal is receiving care.
Not have any claims against the principal's estate.
Witness the signing of the document or the principal's acknowledgment of their signature.

South Carolina Advance Health Care Directive Revocation & Changing

South Carolina's advance directive becomes effective when the principal is unable to make or communicate their own medical decisions. This typically occurs if the principal is unconscious, incapacitated, or suffering from advanced dementia or severe illness.

According to Section 44-77-80, a principal can revoke an advance directive for health care at any time through various methods, such as by:

Tearing, defacing, or destroying it
Providing a signed and dated written statement expressing the intent to revoke
Orally declaring their intent to revoke it
Signing a new advance directive form, which automatically revokes the previous one

A named designee in the directive can revoke it in writing or verbally if the principal is incapacitated and unable to revoke it themself. In all cases, the attending physician must document the revocation in the medical records.

Additional Legal Considerations for South Carolina Advance Health Care Directive

According to Section 44-77-100, if a physician or health care facility chooses not to honor a patient’s advance directive regarding withholding or withdrawing life-sustaining procedures, they must make a reasonable effort to find another physician or facility that will.

If a nurse or other staff member objects to implementing the directive, the facility must still honor the directive by finding a way to proceed without that employee’s involvement.

Section 44-77-120 ensures that no one can be forced to sign an advance directive as a condition for getting health insurance, receiving medical treatment, or being admitted to a hospital or nursing home.

How to Choose a Health Care Agent in South Carolina

Choosing a South Carolina health care proxy (agent) is an important decision that requires careful consideration. The agent should be someone you trust to make medical decisions that align with your wishes, such as a close family member or friend. The agent must be at least 18 years old and mentally competent.

South Carolina law prohibits your doctor or health care provider from serving as your agent unless they are family members. With that in mind, ensure that the person you choose is willing to take on this responsibility and understands your medical preferences clearly.

What Happens if You Don’t Have an Advance Directive in South Carolina?

If you don’t have an advance directive in South Carolina and are unable to communicate your medical preferences, you may not get the treatment you wish for. Without legally documented preferences, health care providers will rely on family members or close friends who will make decisions they believe are in your best interest.

This situation can lead to confusion, disagreement, or decisions that don’t align with your desires.