GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 1115
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Short Title: GSC Advance Health Care Planning Documents. |
(Public) |
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Sponsors: |
Representative Davis. For a complete list of sponsors, refer to the North Carolina General Assembly web site. |
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Referred to: |
Judiciary 1, if favorable, Rules, Calendar, and Operations of the House |
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April 30, 2026
A BILL TO BE ENTITLED
AN ACT to modify the general statutes regarding Health Care powers of attorney, advance health care directives, and advance instructions for mental health treatment based, in part, on proposals in the uniform health‑care decisions act, as recommended by the general statutes commission.
The General Assembly of North Carolina enacts:
part i. findings
SECTION 1. The General Statutes Commission, pursuant to its charge under G.S. 164‑13, finds that the adoption of certain proposals in the 2023 Uniform Health‑Care Decisions Act would improve the laws of this State. Among these proposals is simplifying execution requirements for health care powers of attorney, advance health care directives ("living wills"), and advance instructions for mental health treatment.
The Commission further finds that House Bill 349, 2025 Regular Session, would simplify execution requirements for health care powers of attorney and advance health care directives ("living wills"), two of the three documents for which the General Statutes Commission recommends simplifying execution requirements. In addition to making technical corrections, this act in its entirety provides for all recommendations of the General Statutes Commission resulting from its consideration of the 2023 Uniform Health‑Care Decisions Act. Parts II and III of this act would ensure the enactment of all of the Commission's recommendations if House Bill 349 does or does not become law.
Part I‑A. explain the relationship between a health care power of attorney and other advance health care planning documents
SECTION 1A.(a) G.S. 32A‑15 reads as rewritten:
"§ 32A‑15. General purpose of this Article.
(c) This Article is intended
and shall be construed to be consistent with the provisions of Article
23 (Advance Directive For A Natural Death ("Living Will")) of
Chapter 90 of the General Statutes provided that in Statutes. In the
event of a conflict between the provisions of this Article and Article 23 of
Chapter 90, 90 of the General Statutes, the provisions of Article
23 of Chapter 90 of the General Statutes control. No conflict between
these Chapters exists when either a health care power of attorney or a
declaration provides that the declaration is subject to decisions of a health
care agent. If no declaration has been executed by the principal as provided in
G.S. 90‑321 that expressly covers the principal's present condition
and if the health care agent has been given the specific authority in a health
care power of attorney to authorize the withholding or discontinuing of life‑prolonging
measures when the principal is in such that condition, the
measures may be withheld or discontinued as provided in the health care power
of attorney upon the direction and under the supervision of the attending
physician, as G.S. 90‑322 shall does not apply in such
this case. Nothing in this Article shall be construed to
authorize authorizes any affirmative or deliberate act or omission
to end life other than to permit the natural process of dying.
(d) This Article is intended
and shall be construed to be consistent with the provisions of Part 3A (Revised
Uniform Anatomical Gift Act) of Article 16 of Chapter 130A of the General
Statutes. In the event of a conflict between the provisions of this Article and
Part 3A of Article 16 of Chapter 130A, the provisions of Part 3A of Article 16
of Chapter 130A of the General Statutes control."
"§ 32A‑15.1. Combining health care planning documents.
(a) A health care power of attorney may be combined with any other advance health care planning document, such as:
(1) An advance directive for a natural death ("living will") prepared pursuant to Article 23 of Chapter 90 of the General Statutes.
(2) An advance instruction for mental health treatment prepared pursuant to Part 2 of Article 3 of Chapter 122C of the General Statutes.
(b) A health care power of attorney that is combined with other advance health care planning documents shall be clearly titled as combined, and each type of advance health care planning document within it shall also be individually titled."
SECTION 1A.(c) G.S. 32A‑16(1), (1a), (7), and (8) are recodified as G.S. 32A‑16(1d), (1f), (1), and (4b), respectively.
SECTION 1A.(d) G.S. 32A‑16, as amended by Section 1A(c) of this act, reads as rewritten:
"§ 32A‑16. Definitions.
The following definitions apply in this Article:
(1) Advance instruction for
mental health treatment or advance instruction. As defined in
G.S. 122C‑72(1).Defined in G.S. 122C‑72.
(1a) Recodified.
(1b) Reserved.
(1c) Reserved.
(1d) Disposition of remains. The decision to bury or cremate human remains, as human remains are defined in G.S. 90‑210.121, and, subject to G.S. 32A‑19(b), arrangements relating to burial or cremation.
(1e) Reserved.
(1f) Health care. Any care,
treatment, service, or procedure to maintain, diagnose, treat, or provide for
the principal's physical or mental health or personal care and comfort comfort,
including life‑prolonging measures. "Health care" The
term includes mental health treatment as defined in subdivision (8) of this
section.
(2) Health care agent. The person appointed as a health care attorney‑in‑fact.
(3) Health care power of
attorney. Except as provided in G.S. 32A‑16.1, a written
instrument that substantially meets the requirements of this Article, that is
signed in the presence of two qualified witnesses, and acknowledged before a
notary public, pursuant to which and that appoints an attorney‑in‑fact
or agent is appointed to act for the principal in matters relating to
the health care of the principal. The notary who takes the acknowledgement may
but is not required to be a paid employee of the attending physician or mental
health treatment provider, a paid employee of a health facility in which the
principal is a patient, or a paid employee of a nursing home or any adult care
home in which the principal resides.
(4) Life‑prolonging
measures. Medical procedures or interventions which that, in
the judgment of the attending physician physician, would serve
only to postpone artificially the moment of death by sustaining, restoring, or
supplanting a vital function, including mechanical ventilation, dialysis,
antibiotics, artificial nutrition and hydration, and similar forms of
treatment. Life‑prolonging measures do not include care necessary to
provide comfort or to alleviate pain.
(4a) Reserved.
(4b) Mental health treatment.
The process of providing for the physical, emotional, psychological, and social
needs of the principal for the principal's mental illness. "Mental
health treatment" The term includes electroconvulsive
treatment, treatment of mental illness with psychotropic medication, and
admission to and retention in a facility for care or treatment of mental
illness.
(4c) Reserved.
(4d) Present condition. The condition of the principal when a physician seeks informed consent to withhold or discontinue life‑prolonging measures for the principal.
(5) Principal. The person making the health care power of attorney.
(6) Qualified witness.
Except as provided in G.S. 32A‑16.1, a witness in whose presence the
principal has executed the health care power of attorney, who believes the
principal to be of sound mind, and who states that he or she (i) is not related
within the third degree to the principal nor to the principal's
spouse, by blood, marriage, or adoption, (ii) does not know nor have
a reasonable expectation that he or she would be entitled to any portion of the
estate of the principal upon the principal's death under any existing will or
codicil of the principal or under the Intestate Succession Act as it then
provides, Act, Chapter 29 of the General Statutes, (iii) is not the
attending physician or mental health treatment provider of the principal, nor
a licensed health care provider who is a paid employee of the attending
physician or mental health treatment provider, nor a paid employee of a
health facility in which the principal is a patient, nor or a
paid employee of a nursing home or any adult care home in which the principal
resides, and (iv) does not have a claim against any portion of the estate of
the principal at the time of the principal's execution of the health care power
of attorney.
(7) Recodified.
(8) Recodified."
SECTION 1A.(e) G.S. 32A‑19 reads as rewritten:
"§ 32A‑19. Extent of authority; limitations of authority.
(a1) A health care power of
attorney may incorporate or be combined with an advance instruction for mental
health treatment prepared pursuant to Part 2 of Article 3 of Chapter 122C of
the General Statutes. A health care agent's decisions about mental health
treatment shall be consistent with any statements the principal has expressed
in an advance instruction for mental health treatment under Part 2 of Article
3 of Chapter 122C of the General Statutes, if one so exists, and if none
exists, shall be consistent with what the agent believes in good faith to be
the manner in which the principal would act if the principal did not lack
capacity to make or communicate health care decisions. A health care agent is
not subject to criminal prosecution, civil liability, or professional
disciplinary action for any action taken in good faith pursuant to an advance
instruction for mental health treatment.
(b) A health care power of
attorney may authorize the health care agent to exercise any and all rights the
principal may have with respect to anatomical gifts, the authorization of any
autopsy, and the disposition of remains; provided this remains, so
long as this authority is limited to incurring reasonable costs related to
exercising these powers, and a health care power of attorney does not give
the health care agent general authority over a principal's property or
financial affairs.powers.
(c) A health care power of
attorney may contain, and the authority of the health care agent shall be is
subject to, the specific limitations or restrictions as the principal deems
appropriate.
(d) The powers and authority
granted to the health care agent pursuant to a health care power of attorney shall
be are limited to the matters addressed in it, and, except as
necessary to exercise such those powers and authority relating to
health care, shall do not confer any power or authority with
respect to the property or financial affairs of the principal.
(e) This Article shall
not be construed to does not invalidate a power of attorney that
authorizes an agent to make health care decisions for the principal, which principal
that was executed prior to October 1, 1991.
."
SECTION 1A.(f) G.S. 32A‑25.1 reads as rewritten:
"§ 32A‑25.1. Statutory form health care power of attorney.
(a) The use of the following
form in the creation of a health care power of attorney is lawful and, when
used, it shall meet meets the requirements of and be construed
in accordance with the provisions of this Article:
HEALTH CARE POWER OF ATTORNEY
1. Designation of Health Care Agent.
I, __________________, being of sound mind, hereby appoint the following person(s) to serve as my health care agent(s) to act for me and in my name (in any way I could act in person) to make health care decisions for me as authorized in this document. My designated health care agent(s) shall serve alone, in the order named.
Any successor health care agent
designated shall be vested with the same power and duties as if originally
named as my health care agent, agent and shall serve any time his
or her predecessor is not reasonably available or is unwilling or unable to
serve in that capacity.
2. Effectiveness of Appointment.
My designation of a health care agent
expires only when I revoke it. Absent revocation, the authority granted in this
document shall become becomes effective when and if one of the
physician(s) listed below determines that I lack capacity to make or communicate
decisions relating to my health care, care and will continue in
effect during that incapacity, incapacity or until my death,
except death; however, if I authorize my health care agent to
exercise my rights with respect to anatomical gifts, autopsy, or disposition of
my remains, this authority will continue after my death to the extent necessary
to exercise that authority.
4. General Statement of Authority Granted.
Subject to any restrictions set forth in Section 5 below, I grant to my health care agent full power and authority to make and carry out all health care decisions for me. These decisions include, but are not limited to:
A. Requesting, reviewing, and
receiving any information, verbal or written, regarding my physical or mental
health, including, but not limited to, medical and hospital records, and to
consent consenting to the disclosure of this information.
F. Giving consent for,
withdrawing consent for, or withholding consent for, for X‑ray,
anesthesia, medication, surgery, and all other diagnostic and treatment
procedures ordered by or under the authorization of a licensed physician,
dentist, podiatrist, or other health care provider. This authorization
specifically includes the power to consent to measures for relief of pain.
G. Authorizing the withholding or withdrawal of life‑prolonging measures.
H. Providing my medical
information at the request of any individual acting as my attorney‑in‑fact
under a durable power of attorney or as a Trustee or successor Trustee under
any Trust Agreement of which I am a Grantor or Trustee, or at the request of
any other individual whom my health care agent believes should have such this
information. I desire that such this information be provided
whenever it would expedite the prompt and proper handling of my affairs or the
affairs of any person or entity for which I have some responsibility. In
addition, I authorize my health care agent to take any and all legal steps
necessary to ensure compliance with my instructions providing access to my protected
health information. Such These steps shall include
resorting to any and all legal procedures in and out of courts as may be
necessary to enforce my rights under the law and shall include attempting
to recover attorneys' fees against anyone who that does not
comply with this health care power of attorney.
J. Taking any lawful
actions that may be necessary to carry out these decisions, including, but not
limited to: (i) signing, executing, delivering, and acknowledging any
agreement, release, authorization, or other document that may be necessary,
desirable, convenient, or proper in order to exercise and carry out any of
these powers; (ii) granting releases of liability to medical providers or
others; and (iii) incurring reasonable costs on my behalf related to exercising
these powers, provided that this powers. This health care power
of attorney shall not attorney, however, does not give my health
care agent general authority over my property or financial affairs.
5. Special Provisions and Limitations.
______________ B. Limitations
Concerning Health Care Decisions. In exercising
(Initial) the authority to make health
care decisions on my behalf, the
authority of my health care agent
is subject to the following
special provisions: (Here you may
include any specific
provisions you deem appropriate
such as: your own definition
of when life‑prolonging
measures should be withheld or
discontinued, or instructions to
refuse any specific types of
treatment that are inconsistent
with your religious beliefs, beliefs or
are unacceptable to you for any
other reason.)
__________________________________________________
__________________________________________________
NOTE: DO NOT initial unless you insert a limitation.
8. Reliance of Third Parties on Health Care Agent.
A. No person who relies in
good faith upon the authority of or any representations by my health care agent
shall be is liable to me, my estate, my heirs, successors,
assigns, or personal representatives, representatives for actions
or omissions in reliance on that authority or those representations.
B. The powers conferred on my
health care agent by this document may be exercised by my health care agent
alone, and my health care agent's signature or action taken under the authority
granted in this document may be accepted by persons as fully authorized by me
and with the same force and effect as if I were personally present, competent,
and acting on my own behalf. All acts performed in good faith by my health care
agent pursuant to this power of attorney are done with my consent and shall have
the same validity and effect as if I were present and exercised the powers myself,
myself and shall inure to the benefit of and bind me, my
estate, my heirs, successors, assigns, and personal representatives. The
authority of my health care agent pursuant to this power of attorney shall
be is superior to and binding upon my family, relatives, friends, and
others.
9. Miscellaneous Provisions.
A. Revocation of Prior Powers
of Attorney. I revoke any prior health care power of attorney. The preceding
sentence is not intended to revoke any general powers of attorney, some of the
provisions of which may relate to health care; however, this power of attorney shall
take takes precedence over any health care provisions in any valid
general power of attorney I have not revoked.
B. Jurisdiction,
Severability, and Durability. This Health Care Power of Attorney is intended to
be valid in any jurisdiction in which it is presented. The powers delegated
under this power of attorney are severable, severable so that the
invalidity of one or more powers shall does not affect any
others. This power of attorney shall will not be affected or
revoked by my incapacity or mental incompetence.
D. No Civil or Criminal
Liability. No act or omission of my health care agent, or of any other person,
entity, institution, or facility acting in good faith in reliance on the
authority of my health care agent pursuant to this Health Care Power of
Attorney shall be considered suicide, nor the cause of my death for any civil
or criminal purposes, nor shall it be considered unprofessional conduct or as
lack of professional competence. Any person, entity, institution, or facility
against whom which criminal or civil liability is asserted
because of conduct authorized by this Health Care Power of Attorney may interpose
this document as a defense.
E. Reimbursement. My health
care agent shall be is entitled to reimbursement for all
reasonable expenses incurred as a result of carrying out any provision of this
directive.
I hereby state that the principal,
_______________, being of sound mind, signed (or directed another to sign on
the principal's behalf) the foregoing health care power of attorney in my
presence, and that I am not related to the principal by blood or
marriage, blood, marriage, or adoption, and I would not be entitled
to any portion of the estate of the principal under any existing will or
codicil of the principal or as an heir under the Intestate Succession Act, Chapter
29 of the General Statutes, if the principal died on this date without a
will. I also state that I am not the principal's attending physician, nor physician
or mental health treatment provider and
that I am not a licensed health care
provider or mental health treatment provider who is (1) an employee of the
principal's attending physician or mental health treatment provider, (2) an
employee of the health facility in which the principal is a patient, or (3) an
employee of a nursing home or any adult care home where the principal resides.
I further state that I do not have any claim against the principal or the
estate of the principal.
."
SECTION 1A.(g) G.S. 32A‑26 is repealed.
Part I‑B. explain the relationship between an advance directive ("Living Will") and other advance health care planning documents; update the list of individuals who can provide consent on behalf of a patient who lacks capacity and has no living will in place
SECTION 1B.(a) The title of Article 23 of Chapter 90 of the General Statutes reads as rewritten:
"Article 23.
"Right to Natural
Death; Brain Death.Advance Directive For A Natural Death ("Living
Will")."
SECTION 1B.(b) G.S. 90‑320 reads as rewritten:
"§ 90‑320. General purpose of Article.
(a) The General Assembly
recognizes as a matter of public policy that an individual's rights include the
right to a peaceful and natural death and that a patient or the patient's
representative has the fundamental right to control the decisions relating to
the rendering of the patient's own medical care, including the decision to have
life‑prolonging measures withheld or withdrawn in instances of a terminal
condition. This The purpose of this Article is to establish an
optional and nonexclusive procedure by which a patient or the patient's
representative may exercise these rights. A military advanced medical directive
executed in accordance with 10 U.S.C. § 1044 or other applicable law is valid
in this State.
(b) Nothing in this Article shall
be construed to authorize authorizes any affirmative or deliberate
act or omission to end life other than to permit the natural process of dying.
Nothing in this Article shall impair or supersede impairs or
supersedes any legal right or legal responsibility which any a person
may have to effect the withholding or withdrawal of life‑prolonging
measures in any lawful manner. In such respect the provisions of this
Article are cumulative."
"§ 90‑320.1. Combining health care planning documents.
(a) An advance directive under this Article may be combined with any other advance health care planning document, such as:
(1) A health care power of attorney prepared pursuant to Article 3 of Chapter 32A of the General Statutes.
(2) An advance instruction for mental health treatment prepared pursuant to Part 2 of Article 3 of Chapter 122C of the General Statutes.
(b) An advance directive for a natural death ("living will") that is combined with other advance health care planning documents shall be clearly titled as combined, and each type of advance health care planning document within it shall also be individually titled."
SECTION 1B.(d) G.S. 90‑321 reads as rewritten:
"§ 90‑321. Right to a natural death.
(a) The following definitions apply in this Article:
(2a) Life‑prolonging
measures. As defined in G.S. 32A‑16(4).Defined in G.S. 32A‑16.
(3) Physician. Any person
licensed to practice medicine under Article 1 of Chapter 90 of the laws of
the State of North Carolina.General Statutes.
(3a) Present condition. The condition of the principal when a physician seeks informed consent to withhold or discontinue life‑prolonging measures for the principal.
(4) Repealed by Session Laws 2007‑502, s. 11(a), effective October 1, 2007.
(b) If a person has
expressed through a declaration, in accordance with subsection (c) of this
section, a desire that the person's life not be prolonged by life‑prolonging
measures, and the declaration has not been revoked in accordance with
subsection (e) of this section; andsection, then the life‑prolonging
measures identified by the declarant shall or may, as specified by the
declarant, be withheld or discontinued at the direction and under the
supervision of the attending physician when both of the following apply:
(1) It is determined by the
attending physician that the declarant's present condition is a condition
described in subsection (c) of this section and specified in the declaration
for applying the declarant's directives, anddirectives.
(2) There is confirmation of
the declarant's present condition as set out in subdivision (b)(1) of this
section by a physician other than the attending physician;physician.
then the life‑prolonging
measures identified by the declarant shall or may, as specified by the
declarant, be withheld or discontinued upon the direction and under the
supervision of the attending physician.
(c) The attending physician
shall follow, subject to subsections (b), (e), and (k) of this section, a declaration:declaration
to which all of the following apply:
(1) That It expresses
a desire of the declarant that life‑prolonging measures not be used to
prolong the declarant's life if, as specified in the declaration as to any
or all in the event of one or more of the following:
a. The declarant has an
incurable or irreversible condition that will result in the declarant's death
within a relatively short period of time; ortime.
b. The declarant becomes
unconscious and, to a high degree of medical certainty, will never regain consciousness;
orconsciousness.
(2) That It states
that the declarant is aware that the declaration authorizes a physician to
withhold or discontinue the life‑prolonging measures; andmeasures.
(3) Except as provided in
G.S. 90‑321.1, that it has been signed by the
declarant in the presence of two witnesses who believe the declarant to be of
sound mind and who state that they (i) are not related within the third
degree to the declarant or to the declarant's spouse, by blood, marriage,
or adoption, (ii) do not know or have a reasonable expectation that they would
be entitled to any portion of the estate of the declarant upon the declarant's
death under any will of the declarant or codicil thereto to any will then
existing or under the Intestate Succession Act as it then provides, Act,
Chapter 29 of the General Statutes, (iii) are not the attending physician,
licensed health care providers who are paid employees of the attending
physician, paid employees of a health facility in which the declarant is a
patient, or paid employees of a nursing home or any adult care home in which
the declarant resides, and (iv) do not have a claim against any portion of the
estate of the declarant at the time of the declaration; anddeclaration.
(4) That It has
been proved before a clerk or assistant clerk of superior court, or a notary
public who certifies substantially as set out in subsection (d1) of this
section. A notary who takes the acknowledgement may but is not required to be a
paid employee of the attending physician, a paid employee of a health facility
in which the declarant is a patient, or a paid employee of a nursing home or
any adult care home in which the declarant resides.
(d) Repealed by Session Laws 2007‑502, s. 11(b), effective October 1, 2007.
(d1) The following form is
specifically determined to meet meets the requirements of subsection
(c) of this section:
ADVANCE DIRECTIVE FOR A NATURAL DEATH ("LIVING WILL")
If you want to use this form, you
must complete it, sign it, and have your signature witnessed by two qualified
witnesses and proved by a notary public. Follow the instructions about which
choices you can initial very carefully. Do not sign this form until two
witnesses and a notary public are present to watch you sign it. You then should
consider giving a copy to your primary physician and/or and a
trusted relative, and should consider filing it with the Advanced Health Care
Directive Registry maintained by the North Carolina Secretary of State: http://www.nclifelinks.org/ahcdr/
1. When My Directives Apply
_________ I
suffer from advanced dementia or any other condition
(Initial) which that results
in the substantial loss of my cognitive ability
and my health care providers
determine that, to a high
degree of medical certainty, this
loss is not reversible.
7. My Health Care Providers May Rely on this Directive
My health
care providers shall are not be liable to me or to my
family, my estate, my heirs, or my personal representative for following the
instructions I give in this instrument. Following my directions shall not be
considered suicide, or the cause of my death, or malpractice or
unprofessional conduct. If I have revoked this instrument but my health care
providers do not know that I have done so, and they follow the instructions in
this instrument in good faith, they shall be are entitled to the
same protections to which they would have been entitled if the instrument had
not been revoked.
8. I Want this Directive to be Effective Anywhere
I intend that this Advance Directive be followed by any health care provider in any place.
I hereby state that the declarant,
______________________, being of sound mind, signed (or directed another to
sign on declarant's behalf) the foregoing Advance Directive for a Natural Death
in my presence, and that I am not related to the declarant by blood
or marriage, blood, marriage, or adoption, and I would not be
entitled to any portion of the estate of the declarant under any existing will
or codicil of the declarant or as an heir under the Intestate Succession Act, Chapter
29 of the General Statutes, if the declarant died on this date without a
will. I also state that I am not the declarant's attending physician, nor physician
or a licensed health care provider who is (1) an employee of the
declarant's attending physician, (2) nor an employee of the health
facility in which the declarant is a patient, or (3) an employee of a nursing
home or any adult care home where the declarant resides. I further state that I
do not have any claim against the declarant or the estate of the declarant.
(e) A declaration may be
revoked by the declarant, in writing or in any manner by which the declarant is
able to communicate the declarant's intent to revoke in a clear and consistent
manner, without regard to the declarant's mental or physical condition. A
health care provider shall have has no liability for acting in
accordance with a revoked declaration unless the provider has actual notice of
the revocation. A health care agent may not is not authorized to revoke
a declaration unless the health care power of attorney explicitly authorizes
that revocation; however, a health care agent may exercise any authority
explicitly given to the health care agent in a declaration. A guardian of the
person of the declarant or general guardian may not is not authorized
to revoke a declaration.
(f) The execution and
consummation of declarations made in accordance with subsection (c) shall of
this section does not for any purpose constitute suicide for any
purpose.suicide.
(g) No person shall be required to sign a declaration in accordance with subsection (c) of this section as a condition for becoming insured under any insurance contract or for receiving any medical treatment.
(h) The withholding or
discontinuance of life prolonging measures 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 or a lack of professional
competence. Any person, institution or institution, or facility
against whom which criminal or civil liability is asserted
because of conduct in compliance with this section may interpose this section
as a defense. The protections of this section extend to any valid declaration,
including a document valid under subsection (l) of this section;
these section. These protections are not limited to declarations
prepared in accordance with the statutory form provided in subsection (d1) of
this section, section or to declarations filed with the Advance
Health Care Directive Registry maintained by the Secretary of State. A health
care provider may rely in good faith on an oral or written statement by legal
counsel that a document appears to meet the statutory requirements for a
declaration.
(j) The form provided by this section may be
combined with or incorporated into a health care power of attorney form meeting
the requirements of Article 3 of Chapter 32A of the General Statutes; provided,
however, that the resulting form shall be signed, witnessed, and proved in
accordance with the provisions of this section.
(k) Notwithstanding
subsection (c) of this section:section, the following apply:
(1) An attending physician
may decline to honor a declaration that expresses a desire of the declarant
that life‑prolonging measures not be used if doing so would violate that
physician's conscience or the conscience‑based policy of the facility at
which the declarant is being treated; provided, an treated. An attending
physician who declines to honor a declaration on these grounds must shall
not interfere, interfere and must shall reasonably cooperate
reasonably, with efforts to either substitute an attending
physician whose conscience would not be violated by honoring the declaration,
declaration or transfer the declarant to a facility that does not
have policies in force that prohibit honoring the declaration.
(2) An attending physician
may decline to honor a declaration if if, after reasonable inquiry
inquiry, there are reasonable grounds to question the genuineness or
validity of a declaration. The subsection This subdivision imposes
no duty on the attending physician to verify a declaration's genuineness or
validity.
(l) Notwithstanding
subsection (c) of this section, a declaration or similar document executed in a
jurisdiction other than North Carolina shall be is valid in this
State if it appears to have been executed in accordance with the applicable
requirements of that jurisdiction or this State."
SECTION 1B.(e) G.S. 90‑322 reads as rewritten:
"§ 90‑322. Procedures for natural death in the absence of a declaration.
(a) If the attending physician determines, determines
to a high degree of medical certainty, certainty that a
person lacks capacity to make or communicate health care decisions and the
person will never regain that capacity, and:then life‑prolonging
measures may be withheld or discontinued in accordance with subsection (b) of
this section when all of the following apply:
(1) Repealed by Session Laws 2007‑502, s. 12, effective October 1, 2007.
(1a) That the person:
a. Has Either the person has an
incurable or irreversible condition that will result in the person's death
within a relatively short period of time; or
b. Is time or the person is unconscious
and, to a high degree of medical certainty, will never regain consciousness;
andconsciousness.
(2) There is confirmation of
the person's present condition as set out above in this subdivisions
(1a) and (3) of this subsection, in writing by a physician other than the
attending physician; andphysician.
(3) A vital bodily function
of the person could be restored or is being sustained by life‑prolonging measures;measures.
(4) Repealed by Session Laws 2007‑502, s. 12, effective October 1, 2007.
then, life‑prolonging
measures may be withheld or discontinued in accordance with subsection (b) of
this section.
(b) If a person's patient's
condition has been determined to meet the conditions set forth in
subsection (a) of this section and no instrument has been executed as provided
in G.S. 90‑321, then life‑prolonging measures may be withheld
or discontinued upon the direction and under the supervision of the attending
physician with the concurrence of the following persons, with priority in
the order indicated:
(1) A guardian of the
patient's person, or a general guardian with powers over the patient's person,
appointed by a court of competent jurisdiction pursuant to Article 5 of Chapter
35A of the General Statutes; provided that, if Statutes. However, if the
patient has a health care agent appointed pursuant to a valid health care power
of attorney, the health care agent shall have has the right to
exercise the authority to the extent granted in the health care power of
attorney and to the extent provided in G.S. 32A‑19(b) G.S. 32A‑19(a),
unless the Clerk clerk of superior court has suspended the
authority of that health care agent in accordance with G.S. 35A‑1208(a).
(2) A health care agent appointed pursuant to a valid health care power of attorney, to the extent of the authority granted.
(3) An agent, with powers to make health care decisions for the patient, appointed by the patient, to the extent of the authority granted.
(4) The patient's spouse.
(5) A majority of the patient's reasonably available parents and children who are at least 18 years of age.
(5a) An individual who has an established relationship with the patient, who is acting in good faith on behalf of the patient, who can reliably convey the patient's wishes, and who has been living with the patient for at least one year.
(6) A majority of the patient's reasonably available siblings who are at least 18 years of age.
(6a) A majority of the patient's reasonably available grandparents or grandchildren who are at least 18 years of age.
(6b) An individual not listed in this subsection who is acting in good faith on behalf of the patient and who has assisted the patient with supported decision making routinely during the preceding six months. As used in this subdivision, "supported decision making" means assistance that is provided by one or more individuals of the patient's choosing and that helps the patient make or communicate a decision, including by helping the patient understand the nature and consequences of the decision.
(6c) A majority of the patient's reasonably available stepchildren who are at least 18 years of age, whom the patient actively parented during their minor years, and with whom the patient has an ongoing relationship.
(7) An individual not otherwise listed in this subsection who has an established relationship with the patient, who is acting in good faith on behalf of the patient, and who can reliably convey the patient's wishes.
If none of the above is reasonably available
then available, then, at the discretion of the attending physician
physician, the life‑prolonging measures may be withheld or
discontinued upon the direction and under the supervision of the attending
physician.
(c) Repealed by Session Laws 1979, c. 715, s. 2.
(c1) In order to establish the authority of a person listed in subsection (b) of this section, the attending physician may request and rely upon a statement from the person affirming the person's status under subsection (b) of this section. A physician may accept the concurrence of a person having lower priority under subsection (b) of this section only if a person having higher priority is not reasonably available.
(d) The withholding or
discontinuance of such life‑prolonging measures pursuant to
this section shall not be considered the cause of death for any civil or
criminal purpose nor shall it be considered unprofessional conduct. Any person,
institution or facility against whom which criminal or civil
liability is asserted because of conduct in compliance with this section may
interpose this section as a defense."
Part I‑C. simplify execution requirements for an advance instruction for mental health treatment and explain its relationship to other advance health care planning documents
SECTION 1C.(a) G.S. 122C‑71 reads as rewritten:
"§ 122C‑71. Purpose.
(c) This Part is intended
and shall be construed to be consistent with the provisions of Article 3
(Health Care Powers of Attorney) of Chapter 32A of the General Statutes,
provided that in Statutes. In the event of a conflict between the
provisions of this Part and Article 3 of Chapter 32A, 32A of the
General Statutes, the provisions of this Part control."
"§ 122C‑71.1. Combining advance planning documents.
(a) An advance instruction for mental health treatment may be combined with a general power of attorney prepared pursuant to Chapter 32C of the General Statutes or any other advance health care planning document, such as:
(1) A health care power of attorney prepared pursuant to Article 3 of Chapter 32A of the General Statutes.
(2) An advance directive for a natural death ("living will") prepared pursuant to Article 23 of Chapter 90 of the General Statutes.
(b) An advance instruction for mental health treatment that is combined with other advance health care planning documents shall be clearly titled as combined, and each type of advance health care planning document within it shall also be individually titled."
SECTION 1C.(c) G.S. 122C‑72 reads as rewritten:
"§ 122C‑72. Definitions.
As used in this Part, unless the context clearly requires otherwise, the following terms have the meanings specified:
(1) "Advance
instruction for mental health treatment" or "advance
instruction" means a Advance instruction for mental health
treatment or advance instruction. A written instrument, instrument
that is either signed in the presence of two qualified witnesses who
believe the principal to be of sound mind at the time of the signing, and signing
or acknowledged before a notary public, pursuant to which the principal
makes a declaration of instructions, information, and preferences regarding the
principal's mental health treatment and states that the principal is aware that
the advance instruction authorizes a mental health treatment provider to act
according to the instruction. It may also state the principal's instructions
regarding, but not limited to, consent to or refusal of mental health treatment
when the principal is incapable.
(2) "Attending
physician" means the Attending physician. The physician who
has primary responsibility for the care and treatment of the principal.
(3) Repealed by Session Laws 1998‑198, s. 2.
(4) "Incapable"
means that, in Incapable. In the opinion of a physician or
eligible psychologist, the person currently person, at the time a
mental health treatment decision is being made, lacks sufficient
understanding or capacity to make and communicate mental health treatment
decisions. As used in this Part, the term "eligible psychologist" has
the meaning given in G.S. 122C‑3(13d).
(5) "Mental health
treatment" means the Mental health treatment. The process of
providing for the physical, emotional, psychological, and social needs of the
principal for the principal's mental illness. "Mental health
treatment" The term includes, but is not limited to,
electroconvulsive treatment (ECT), commonly referred to as "shock treatment",
treatment," treatment of mental illness with psychotropic
medication, and admission to and retention in a facility for care or treatment
of mental illness.
(6) "Principal"
means the Principal. The person making the advance instruction.
(7) "Qualified
witness" means a Qualified witness. A witness who affirms
that the principal is personally known to the witness, that the principal
signed or acknowledged the principal's signature on the advance instruction in
the presence of the witness, that the witness believes the principal to be of
sound mind and not to be under duress, fraud, or undue influence, and that the
witness is not:not any of the following:
a. The attending physician
or physician, mental health service provider provider, or
an employee of the physician or mental health treatment provider;service
provider.
b. An owner, operator, or an
employee of an owner or operator of a health care facility in which the
principal is a patient or resident; orresident.
c. Related within the
third degree to the principal or to the principal's spouse.by
blood, marriage, or adoption.
d. A person appointed as an attorney‑in‑fact by this document."
SECTION 1C.(d) G.S. 122C‑73 reads as rewritten:
"§ 122C‑73. Scope, use, and authority of advance instruction for mental health treatment.
(d) A principal may nominate,
by advance instruction for mental health treatment, the guardian of the person
of the principal if a guardianship proceeding is thereafter commenced. commenced
following the execution of the advance instruction for mental health treatment.
The court shall make its appointment in accordance with the principal's
most recent nomination in an unrevoked advance instruction for mental health
treatment, except for good cause shown.
(f) An advance instruction for mental health
treatment may be combined with a health care power of attorney or general power
of attorney that is executed in accordance with the requirements of Chapter 32A
or Chapter 32C of the General Statutes so long as each form shall be executed
in accordance with its own statute."
SECTION 1C.(e) G.S. 122C‑77 reads as rewritten:
"§ 122C‑77. Statutory form for advance instruction for mental health treatment.
(a) This Part shall not
be construed to invalidate an advance instruction for mental health treatment
that was executed and was otherwise valid.Use of the statutory form
prescribed in this section is an optional and nonexclusive method for creating
an advance instruction for mental health treatment and does not affect the use or
validity of other forms of advance instruction for mental health treatment, including
previous statutory forms.
(b) The use of the following
or similar form after the effective date of this Part in the creation of
an advance instruction for mental health treatment is lawful, and, when used,
it shall specifically meet the requirements and be construed in accordance with
the provisions of this Part.
PSYCHOACTIVE PSYCHOTROPIC
MEDICATIONS
If I become incapable of giving or
withholding informed consent for mental health treatment, my instructions
regarding psychoactive psychotropic medications are as follows:
(Place initials beside choice.)
SIGNATURE OF PRINCIPAL
Note: Do not sign this form until two witnesses or a notary public are present to watch you sign it. You then should consider giving a copy to your primary physician, mental health provider, and a trusted relative and should consider filing it with the Advance Health Care Directive Registry maintained by the North Carolina Secretary of State.
Box #1
If you elect to have your advance instruction witnessed, have the following section completed by two qualified witnesses:
NATURE AFFIRMATION OF WITNESSES
I hereby state affirm that
the principal is personally known to me, that the principal signed or
acknowledged the principal's signature on this advance instruction for mental
health treatment in my presence, that the principal appears to be of sound mind
and not under duress, fraud, or undue influence, and that I am not:not
any of the following:
a. The attending physician
or physician, mental health service provider provider, or
an employee of the physician or mental health treatment provider;service
provider.
b. An owner, operator, or an
employee of an owner or operator of a health care facility in which the
principal is a patient or resident; orresident.
c. Related within the
third degree to the principal or to the principal's spouse.by
blood, marriage, or adoption.
d. A person appointed as an attorney‑in‑fact by this document.
AFFIRMATION OF WITNESSES
We affirm that the principal is
personally known to us, that the principal signed or acknowledged the
principal's signature on this advance instruction for mental health treatment
in our presence, that the principal appears to be of sound mind and not under
duress, fraud, or undue influence, and that neither of us is:
A person appointed as an attorney‑in‑fact
by this document;
The principal's attending physician
or mental health service provider or a relative of the physician or provider;
The owner, operator, or relative of
an owner or operator of a facility in which the principal is a patient or
resident; or
A person related to the principal by
blood, marriage, or adoption.
Witnessed by:
Witness:_____________________________ (Signature of witness)
_________________________ (type/print name of witness)
Date:_______________________________
Witness:_____________________________ (Signature of witness)
_________________________ (type/print name of witness)
Date:_______________________________
STATE OF NORTH CAROLINA
COUNTY OF____________________________________
Box #2
If you elect to have your advance instruction notarized, have the following section completed by a qualified notary public:
CERTIFICATION OF NOTARY PUBLIC
STATE OF NORTH CAROLINA
COUNTY OF
I, __________________________, a
Notary Public for the County cited above in the State of North Carolina, hereby
certify that ____________________ appeared before me and swore or affirmed to
me and to the witnesses in my presence that this instrument is an advance
instruction for mental health treatment, and that he/she willingly and
voluntarily made and executed it as his/her free act and deed for the purposes
expressed in it.
I further
certify that _____________________and _____________________, witnesses,
appeared before me and swore or affirmed that they witnessed
_________________________ sign the attached advance instruction for mental
health treatment, believing him/her to be of sound mind; and also swore that at
the time they witnessed the signing they were not (i) the attending physician
or mental health treatment provider or an employee of the physician or mental
health treatment provider and (ii) they were not an owner, operator, or
employee of an owner or operator of a health care facility in which the
principal is a patient or resident, and (iii) they were not related within the
third degree to the principal or to the principal's spouse. I further certify
that I am satisfied as to the genuineness and due execution of the instrument.
This is
the ____________ day of__________, _________________________________
____________________________________
Notary
Public
My Commission expires:
________________COUNTY, _________________STATE
Sworn to (or affirmed) and subscribed before me this day by ______________________
(type/print name of principal)
Date: ____________________ _________________________________
(Official Seal) Signature of Notary Public
_____________________, Notary Public
Printed or typed name
My commission expires: ____________
NOTICE TO PERSON MAKING AN INSTRUCTION FOR MENTAL HEALTH TREATMENT
This is an important legal document. It creates an instruction for mental health treatment. Before signing this document you should know these important facts:
This document allows you to make
decisions in advance about certain types of mental health treatment. The
instructions you include in this declaration will be followed if a physician or
eligible psychologist determines that you are incapable of making and communicating
treatment decisions. Otherwise you will be considered capable to give or
withhold consent for the treatments. Your instructions may be overridden if you
are being held in accordance with civil commitment law. Under the Health
Care Power of Attorney a health care power of attorney you may also
appoint a person as your health care agent to make treatment decisions for you
if you become incapable. You have the right to revoke this document at any time
you have not been determined to be incapable. YOU MAY NOT REVOKE THIS ADVANCE
INSTRUCTION WHEN YOU ARE FOUND INCAPABLE BY A PHYSICIAN OR OTHER AUTHORIZED
MENTAL HEALTH TREATMENT PROVIDER. A revocation is effective when it is
communicated to your attending physician or other provider. The physician or
other provider shall note the revocation in your medical record. To be
valid, this advance instruction must be signed by two qualified witnesses,
personally known to you, witnesses who are present when you sign or
acknowledge your signature. It signature, or it must also be
acknowledged before a notary public.
NOTICE TO PHYSICIAN OR OTHER MENTAL HEALTH TREATMENT PROVIDER
Under North Carolina law, a person may
use this advance instruction to provide consent for future mental health
treatment if the person later becomes incapable of making those decisions.
Under the Health Care Power of Attorney a health care power of
attorney the person may also appoint a health care agent to make mental
health treatment decisions for the person when incapable. A person is
"incapable" when in the opinion of a physician or eligible
psychologist the person currently person, at the time a mental health
treatment decision is being made, lacks sufficient understanding or
capacity to make and communicate mental health treatment decisions. This
document becomes effective upon its proper execution and remains valid unless
revoked. Upon being presented with this advance instruction, the physician or
other provider must make it a part of the person's medical record. Upon
communication that it is revoked, the physician or other provider must note the
revocation in the person's medical record. The attending physician or other
mental health treatment provider must act in accordance with the statements
expressed in the advance instruction when the person is determined to be
incapable, unless compliance is not consistent with G.S. 122C‑74(g).
The physician or other mental health treatment provider shall promptly notify
the principal and, if applicable, the health care agent, and document
noncompliance with any part of an advance instruction in the principal's
medical record. The physician or other mental health treatment provider may
rely upon the authority of a signed, witnessed, dated, and notarized advance
instruction, as provided in G.S. 122C‑75."
Part I‑D. additional conforming changes
SECTION 1D.(a) G.S. 90‑21.13 reads as rewritten:
"§ 90‑21.13. Informed consent to health care treatment or procedure.
(a) No recovery shall be is
allowed against any health care provider upon on the grounds
ground that the health care treatment was rendered without the
informed consent of the patient or other another person
authorized to give consent for the patient where:when either of the
following applies:
(1) Both of the following:
a. The action of the health care provider in
obtaining the consent of the patient or other another person
authorized to give consent for the patient was in accordance with the standards
of practice among members of the same health care profession with similar
training and experience situated in the same or similar communities; andcommunities.
(2)b. A reasonable
person, from the information provided by the health care provider under the
circumstances, would have a general understanding of the procedures or
treatments and of the usual and most frequent risks and hazards inherent in the
proposed procedures or treatments which treatments, and these
procedures or treatments are recognized and followed by other health care
providers engaged in the same field of practice in the same or similar communities;
orcommunities.
(3)(2) A reasonable
person, under all the surrounding circumstances, would have undergone such the
treatment or procedure had he the person been advised by the
health care provider in accordance with the provisions of subdivisions (1)
and (2) subdivision (1) of this subsection.
(b) A consent which that
is evidenced in writing and which writing, meets the foregoing
standards, standards of subsection (a) of this section, and which
is signed by the patient who has capacity to make and communicate health
care decisions or other another authorized person, shall
be person is presumed to be a valid consent. This presumption,
however, may be presumption is subject to rebuttal only upon proof
that such the consent was obtained by fraud, deception deception,
or misrepresentation of a material fact. A consent that meets the
foregoing standards, that is given by a patient, or other authorized person, who
under all the surrounding circumstances has capacity to make and communicate
health care decisions, is a valid consent.
(c) The following persons, with priority in the order indicated, are authorized to consent to medical treatment on behalf of a patient who is comatose or otherwise lacks capacity to make or communicate health care decisions:
(1) A guardian of the
patient's person, or a general guardian with powers over the patient's person,
appointed by a court of competent jurisdiction pursuant to Article 5 of Chapter
35A of the General Statutes; provided that, Statutes. However, if
the patient has a health care agent appointed pursuant to a valid health care
power of attorney, the health care agent shall have has the right
to exercise the authority to the extent granted in the health care power of
attorney and to the extent provided in G.S. 32A‑19(a) unless the Clerk
clerk of superior court has suspended the authority of that health
care agent in accordance with G.S. 35A‑1208(a).
(2) A health care agent appointed pursuant to a valid health care power of attorney, to the extent of the authority granted.
(3) An agent, with powers to make health care decisions for the patient, appointed by the patient, to the extent of the authority granted.
(4) The patient's spouse.
(5) A majority of the patient's reasonably available parents and children who are at least 18 years of age.
(5a) An individual who has an established relationship with the patient, who is acting in good faith on behalf of the patient, who can reliably convey the patient's wishes, and who has been living with the patient for at least one year.
(6) A majority of the patient's reasonably available siblings who are at least 18 years of age.
(6a) A majority of the patient's reasonably available grandparents or grandchildren who are at least 18 years of age.
(6b) An individual not listed in this subsection who is acting in good faith on behalf of the patient and who has assisted the patient with supported decision making routinely during the preceding six months. As used in this subdivision, "supported decision making" means assistance that is provided by one or more individuals of the patient's choosing and that helps the patient make or communicate a decision, including by helping the patient understand the nature and consequences of the decision.
(6c) A majority of the patient's reasonably available stepchildren who are at least 18 years of age, whom the patient actively parented during their minor years, and with whom the patient has an ongoing relationship.
(7) An individual not otherwise listed in this subsection who has an established relationship with the patient, who is acting in good faith on behalf of the patient, and who can reliably convey the patient's wishes.
(c1) If none of the persons
listed under subsection (c) of this section is reasonably available, then the
patient's attending physician, in the attending physician's discretion, may
provide health care treatment without the consent of the patient or other person
authorized to consent for the patient if there is confirmation by a physician
other than the patient's attending physician of the patient's condition and the
necessity for treatment; provided, however, treatment. However, that
confirmation of the patient's condition and the necessity for treatment are not
required if the delay in obtaining the confirmation would endanger the life or
seriously worsen the condition of the patient.
(c2) In order to establish the authority of a person listed in subsection (c) of this section, the attending physician may request and rely upon a statement from the person affirming the person's status under subsection (c) of this section. A physician may accept the consent of a person having lower priority under subsection (c) of this section only if a person having higher priority is not reasonably available.
(d) No action may shall
be maintained against any health care provider upon any based on
a guarantee, warranty warranty, or assurance as to the result
of any medical, surgical surgical, or diagnostic procedure or
treatment unless the guarantee, warranty warranty, or assurance,
or some note or memorandum thereof, shall be of it, is in writing
and signed by the provider or by some other another person
authorized to act for or on behalf of such the provider.
(e) In the event of any a
conflict between the provisions of this section and those of G.S. 35A‑1245,
90‑21.17, and 90‑322, G.S. 90‑21.17, Articles
1A and 19 of Chapter 90, 90 of the General Statutes, G.S. 90‑322,
and Article 3 of Chapter 122C of the General Statutes, the provisions of
those sections and Articles shall control and continue in full force and
effect.control."
SECTION 1D.(b) G.S. 130A‑466(b) is repealed.
part II. simplify execution requirements for a health care power of attorney and an advance directive ("living will")
SECTION 2.1.(a) G.S. 32A‑16(3), as amended by Section 1A(d) of this act, reads as rewritten:
"(3) Health care power of
attorney. Except as provided in G.S. 32A‑16.1, a written
instrument that substantially meets the requirements of this Article, that is
signed in the presence of two qualified witnesses, and witnesses or acknowledged
before a notary public, and that appoints an attorney‑in‑fact or
agent to act for the principal in matters relating to the health care of the
principal. The notary who takes the acknowledgement may but is not required to
be a paid employee of the attending physician or mental health treatment
provider, a paid employee of a health facility in which the principal is a
patient, or a paid employee of a nursing home or any adult care home in which
the principal resides."
SECTION 2.1.(b) G.S. 32A‑25.1(a), as amended by Section 1A(f) of this act, reads as rewritten:
"(a) The use of the following form in the creation of a health care power of attorney is lawful and, when used, meets the requirements of and be construed in accordance with the provisions of this Article:
HEALTH CARE POWER OF ATTORNEY
NOTE: YOU SHOULD USE THIS DOCUMENT TO NAME A PERSON AS YOUR HEALTH CARE AGENT IF YOU ARE COMFORTABLE GIVING THAT PERSON BROAD AND SWEEPING POWERS TO MAKE HEALTH CARE DECISIONS FOR YOU. THERE IS NO LEGAL REQUIREMENT THAT ANYONE EXECUTE A HEALTH CARE POWER OF ATTORNEY.
EXPLANATION: You have the right to name someone to make health care decisions for you when you cannot make or communicate those decisions. This form may be used to create a health care power of attorney, and meets the requirements of North Carolina law. However, you are not required to use this form, and North Carolina law allows the use of other forms that meet certain requirements. If you prepare your own health care power of attorney, you should be very careful to make sure it is consistent with North Carolina law.
This document gives the person you designate as your health care agent broad powers to make health care decisions for you when you cannot make the decision yourself or cannot communicate your decision to other people. You should discuss your wishes concerning life‑prolonging measures, mental health treatment, and other health care decisions with your health care agent. Except to the extent that you express specific limitations or restrictions in this form, your health care agent may make any health care decision you could make yourself.
This form does not impose a duty on your health care agent to exercise granted powers, but when a power is exercised, your health care agent will be obligated to use due care to act in your best interests and in accordance with this document.
This Health Care Power of Attorney form is intended to be valid in any jurisdiction in which it is presented, but places outside North Carolina may impose requirements that this form does not meet.
If
you want to use this form, you must complete it, sign it, and have your
signature witnessed by two qualified
witnesses and or proved by a notary public. Follow the
instructions about which choices you can initial very carefully. Do not sign
this form until two witnesses and or a notary public are present
to watch you sign it. You then should give a copy to your health care agent and
to any alternates you name. You should consider filing it with the Advance
Health Care Directive Registry maintained by the North Carolina Secretary of State:
http://www.nclifelinks.org/ahcdr/State.
By signing here, I indicate that I am mentally alert and competent, fully informed as to the contents of this document, and understand the full import of this grant of powers to my health care agent.
This the _____ day of ______________, 20____.
________________________(SEAL)(SIGNATURE)
I hereby state that the principal, _______________, being of sound mind, signed (or directed another to sign on the principal's behalf) the foregoing health care power of attorney in my presence, that I am not related to the principal by blood, marriage, or adoption, and I would not be entitled to any portion of the estate of the principal under any existing will or codicil of the principal or as an heir under the Intestate Succession Act, Chapter 29 of the General Statutes, if the principal died on this date without a will. I also state that I am not the principal's attending physician or mental health treatment provider and that I am not a licensed health care provider or mental health treatment provider who is (1) an employee of the principal's attending physician or mental health treatment provider, (2) an employee of the health facility in which the principal is a patient, or (3) an employee of a nursing home or any adult care home where the principal resides. I further state that I do not have any claim against the principal or the estate of the principal.
Box #1
If you elect to have your declaration witnessed, complete the following section:
Date: _____________________________ Witness: ___________________________
(Signature of witness)
_________________________
(type/print name of witness)
Date: _____________________________ Witness: ___________________________
(Signature of witness)
_________________________
(type/print name of witness)
Box #2
If you elect to have your declaration notarized, have the following section completed by a qualified notary public:
________________COUNTY, _________________STATE
Sworn to (or affirmed) and subscribed before me this day by _____________________
(type/print name of signer)
______________________
(type/print
name of witness)
______________________
(type/print
name of witness)
Date: ___________________________ ______________________________
(Official Seal) Signature of Notary Public
__________________, Notary Public
Printed or typed name
My commission expires: __________"
SECTION 2.2.(a) G.S. 90‑321(c)(3), as amended by Section 1B(d) of this act, reads as rewritten:
"(3) Except as provided in
G.S. 90‑321.1, it either of the following:
a. It has been signed by the declarant in the
presence of two witnesses who believe the declarant to be of sound mind and who
state that they (i) are not related to the declarant by blood, marriage, or
adoption, (ii) do not know or have a reasonable expectation that they would be
entitled to any portion of the estate of the declarant upon the declarant's
death under any will of the declarant or codicil to any will then existing or
under the Intestate Succession Act, Chapter 29 of the General Statutes, (iii)
are not the attending physician, licensed health care providers who are paid
employees of the attending physician, paid employees of a health facility in
which the declarant is a patient, or paid employees of a nursing home or any
adult care home in which the declarant resides, and (iv) do not have a claim
against any portion of the estate of the declarant at the time of the declaration;
anddeclaration.
(4)b. It has been
proved before a clerk or assistant clerk of superior court, or a notary public
who certifies substantially as set out in subsection (d1) of this section. A
notary who takes the acknowledgement may but is not required to be a paid
employee of the attending physician, a paid employee of a health facility in
which the declarant is a patient, or a paid employee of a nursing home or any
adult care home in which the declarant resides."
SECTION 2.2.(b) G.S. 90‑321(a)(1a) reads as rewritten:
"(1a) Declaration. Except
as provided in G.S. 90‑321.1, any signed, witnessed, dated, and proved
signed, witnessed or proved, and dated document meeting the
requirements of subsection (c) of this section."
SECTION 2.2.(c) G.S. 90‑321(d1), as amended by Section 1B(d) of this act, reads as rewritten:
"(d1) The following meets the requirements of subsection (c) of this section:
ADVANCE DIRECTIVE FOR A NATURAL DEATH ("LIVING WILL")
NOTE: YOU SHOULD USE THIS DOCUMENT TO GIVE YOUR HEALTH CARE PROVIDERS INSTRUCTIONS TO WITHHOLD OR WITHDRAW LIFE‑PROLONGING MEASURES IN CERTAIN SITUATIONS. THERE IS NO LEGAL REQUIREMENT THAT ANYONE EXECUTE A LIVING WILL.
GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give instructions for the future if you want your health care providers to withhold or withdraw life‑prolonging measures in certain situations. You should talk to your doctor about what these terms mean. The Living Will states what choices you would have made for yourself if you were able to communicate. Talk to your family members, friends, and others you trust about your choices. Also, it is a good idea to talk with professionals such as your doctors, clergypersons, and lawyers before you complete and sign this Living Will.
You do not have to use this form to give those instructions, but if you create your own Advance Directive you need to be very careful to ensure that it is consistent with North Carolina law.
This Living Will form is intended to be valid in any jurisdiction in which it is presented, but places outside North Carolina may impose requirements that this form does not meet.
If you want to use this form, you
must complete it, sign it, and have your signature witnessed by two qualified
witnesses and or proved by a notary public. Follow the
instructions about which choices you can initial very carefully. Do not sign
this form until two witnesses and or a notary public are
present to watch you sign it. You then should consider giving a copy to your
primary physician and a trusted relative, and should consider filing it with
the Advanced Health Care Directive Registry maintained by the North Carolina
Secretary of State: http://www.nclifelinks.org/ahcdr/State.
My Desire for a Natural Death
I, ____________________, being of sound mind, desire that, as specified below, my life not be prolonged by life‑prolonging measures:
I hereby state that the declarant, ______________________, being of sound mind, signed (or directed another to sign on declarant's behalf) the foregoing Advance Directive for a Natural Death in my presence, and that I am not related to the declarant by blood, marriage, or adoption, and I would not be entitled to any portion of the estate of the declarant under any existing will or codicil of the declarant or as an heir under the Intestate Succession Act, Chapter 29 of the General Statutes, if the declarant died on this date without a will. I also state that I am not the declarant's attending physician or a licensed health care provider who is (1) an employee of the declarant's attending physician, (2) nor an employee of the health facility in which the declarant is a patient, or (3) an employee of a nursing home or any adult care home where the declarant resides. I further state that I do not have any claim against the declarant or the estate of the declarant.
Box #1
If you elect to have your declaration witnessed, complete the following section:
Date: _____________________________ Witness: ___________________________
(Signature of witness)
_________________________
(type/print name of witness)
Date: _____________________________ Witness: ___________________________
(Signature of witness)
_________________________
(type/print name of witness)
Box #2
If you elect to have your declaration notarized, have the following section completed by a qualified notary public:
________________COUNTY, _________________STATE
Sworn to (or affirmed) and subscribed before me this day by _____________________
(type/print name of declarant)
________________________
(type/print
name of witness)
________________________
(type/print
name of witness)
Date ___________________________ ______________________________
(Official Seal) Signature of Notary Public
__________________, Notary Public
Printed or typed name
My commission expires: _________"
part III. contingent repeal and effective date
SECTION 3.(a) If House Bill 349, 2025 Regular Session, becomes law, Part II of this act is repealed.
SECTION 3.(b) This act becomes effective January 1, 2027, and applies to documents executed on or after that date. This act does not affect the validity of a health care power of attorney, an advance directive, or an advance instruction for mental health treatment executed prior to the effective date of this act.