Advance Directive
Living Will and Other Advance Directives
Advance Directives are documents stating your choices about medical treatment, or naming someone to make decisions about your medical treatment, if you’re unable to make these decisions yourself. They’re called “Advance Directives” because they are signed in advance to let your doctor and other healthcare providers know your wishes concerning medical treatment. Advance Directives are legally valid decisions about your future medical care. In North Carolina, they include a Living Will, a Health Care Power of Attorney, and an Instruction for Mental Health Treatment. Carteret Health Care (CHC) supports your right to participate actively in medical and mental health treatment decision-making.
CHC will accept all written Advance Directives that comply with North Carolina legal requirements and will place those Directives in the patient’s medical record. In addition, if you cannot speak for yourself and haven’t made an Advance Directive, your doctor or other healthcare provider will generally look to your family for decisions about your care. If your doctor or healthcare facility is unsure, or if your family members cannot agree, a court may be asked to appoint a person (legal guardian) to make those decisions for you.
The Patient Self-Determination Act does not ask hospitals to force Advance Directives but to help patients and the community understand that they have choices. In order to fulfill this responsibility, CHC will provide written material to adult in-patients and will educate our staff and the community on issues concerning Advance Directives.
Before writing down your instructions, you should talk to the people closest to you and who are concerned about your care and feelings. Be sure to discuss these things with your family, doctor, or possibly your clergy or lawyer. These are the people who may be involved with your healthcare if you’re unable to make your own decisions.
North Carolina has three ways for you to make a formal Advance Directive. One way is called a “Living Will”; the second is called a “Health Care Power of Attorney”; the third is called “Advance Instruction for Mental Health Treatment.”
Living Will
In North Carolina, a Living Will is a document that tells others that you want to die a natural death if you’re terminally and incurably ill, or in a persistent vegetative state from which you will not recover. In a Living Will, you direct your doctor not to use heroic treatments that would delay your dying; for example, by using a breathing machine (“respirator” or “ventilator”) or to stop such treatments if they have been started. You can also direct your doctor not to begin, or to stop, giving you food and water through a tube (“artificial nutrition or hydration“).
Is a Living Will the Same Thing as a “Do Not Resuscitate (DNR) Order?
No. A North Carolina Living Will covers all types of life sustaining treatments. A “DNR” covers two specific situations and is prepared by your doctor at your direction and placed in your medical records. It states that if you suffer cardiac arrest (your heart stops beating) or respiratory arrest (you stop breathing), your health care providers are not to try to revive you by any means.
Health Care Power of Attorney (HCPA)
In North Carolina, you can name a person to make medical or mental health care decisions for you if you later become unable to decide yourself. This person is called your “health care agent.” In the legal document you name who you want your agent to be. You can say what medical treatments you would want and what you would not want. Your agent then knows what choices you would make.
How is the HCPA different from the Living Will?
A Living Will only applies if you‘re terminally ill or if you are in a persistent vegetative state and unless you write in other specific instructions, it only tells your doctor what you do not want. The HCPA allows you to appoint someone to make healthcare decisions for you if you cannot make them. It covers all health care situations in which you are incapable of making decisions for yourself. The HCPA allows your agent to respond to medical situations that you might not have anticipated.
Advance Instruction for Mental Health Treatment (AIMHT)
An AIMHT is a legal document allowing you to tell your doctor and other health care providers about your preferences and instructions regarding your mental health care treatment, if you’re no longer able to make these decisions yourself. This includes electroconvulsive treatment, psychoactive drugs, and admission to, and retention in, a facility for the care and treatment of mental illness.
What if I have an Advance Directive from another state?
An Advance Directive from another state may not meet all of North Carolina’s rules. To be sure about this, you may want to make an Advance Directive in North Carolina, too. Or you could have your lawyer review the advance directive from the other state.
Where can I get more information?
Your health care provider can tell you how to get more information about Advance Directives by contacting:
Carteret Health Care:
Patient/Family Services
252-499-6479, 6235, 6238
Hospital Chaplain
252-499-6402
Clinical Coordinator
252-499-6559
Email Us: wmholland@carterethealth.org
