Most of us want to believe we’ll always be healthy, active and in control of our own decisions. But a sudden accident or serious illness can take away that freedom. When that happens, doctors turn to our loved ones to make medical choices for us. If that happened to you, would your family and friends know what types of treatment you would want? Having a living will and naming a healthcare agent are ways to ensure you have control over your treatment even when you can’t speak for yourself.

It’s important to start having these advance care planning conversations now. It won’t always be easy to talk about. You and your loved ones may have very different opinions. But talking about it now can make a big difference in the future.

There are three main steps to taking control of your future with an advance directive. You can learn more about each step and access forms, instructions and tips:

  1. Think About It
  2. Talk About It
  3. Write It Down

About Advance Care Planning

Advance care planning is an important part of routine healthcare for all adults, no matter how old you are or what medical conditions you have (if any). It’s an ongoing process of thinking and talking about what type of treatment you would want if a sudden illness or injury left you unable to speak for yourself. Knowing your wishes ahead of time is a great gift for your loved ones and can relieve some of the stress they will feel if asked to make decisions for you.

Part of this planning involves choosing a person you trust to make decisions for you. This person is called a healthcare agent. It’s important to involve your healthcare team, your healthcare agent and your loved ones in the conversation to make sure they understand your wishes. It is also important to write down your choices, which can be done using an advance directive.

What is an Advance Directive?

An advance directive is a written record of your medical choices. In North Carolina, an advance directive includes three forms: a healthcare power of attorney, a living will and advance instruction for mental health treatment. In South Carolina, an advance directive includes two forms: a healthcare power of attorney and a living will.

A healthcare power of attorney is a legal form in which you choose another person, called a healthcare agent, to be in charge of your care when you’re not able to make decisions for yourself.

A living will, also known as a declaration of a desire for a natural death, is a legal form that lets you express your wishes about having a natural death by choosing not to receive life-prolonging measures if you:

  • Have an incurable or irreversible condition that will result in death in a short period of time
  • Are unconscious and cannot regain consciousness
  • Have a condition that has led to a substantial loss of your ability to think

An advance instruction for mental health treatment allows you to accept or refuse mental health treatment, including shock treatment, medication, and admission to and treatment in a mental health facility. A form for advance instruction can be obtained by asking your doctor for a copy.

Advance Care Planning Is an Important Topic

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Making Changes to an Advance Directive

You can always make changes to or cancel your advance directive. Once you have signed and completed your forms, it is highly recommended that you review and update them any time you face certain life events. You can learn more about this in Step 3 – Write It Down.

Your Rights As a Patient

The Patient Self-Determination Act requires United States hospitals to provide all adult patients with written information about their right to refuse unwanted medical treatment. We want you to know your rights and responsibilities as a patient at our hospitals.

Carolinas HealthCare System's Policy

Even if you decide to sign a living will or healthcare power of attorney indicating your desire that life-sustaining procedures not be used to artificially prolong your life, you will continue to receive customary medical and nursing care to provide comfort, to alleviate pain and to maintain your dignity. In fact, under North Carolina law, no healthcare agent you appoint has the authority to withhold or discontinue care necessary to provide comfort or alleviate pain.

The principles described above have been included in a written hospital policy on the rights of adult patients to refuse unwanted medical treatment.

Our policy recognizes that an individual has the right to sign a living will, healthcare power of attorney or an advance instruction to express the person's desire for a peaceful and natural death and desire that life-sustaining procedures not be used. We recognize these rights, but in no way discriminate against a person based on whether the individual has signed a living will, healthcare power of attorney or an advance instruction.

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