Homepage Printable Living Will Form for North Carolina
Outline

Most individuals have specific desires regarding their medical care, especially in situations where they can no longer express those wishes personally due to serious illness or incapacity. In North Carolina, a legal instrument called the Living Will form enables residents to outline their preferences for such circumstances in advance. This document, a critical component of healthcare planning, empowers individuals to dictate the extent of medical treatment they wish to receive if they are facing a terminal condition, are in a persistent vegetative state, or suffer from severe dementia, among other situations. It allows people to make difficult decisions ahead of time about life-prolonging treatments, including the use of ventilators, feeding tubes, and other life-sustaining measures. By completing this form, a person ensures that their medical treatment aligns with their values and desires, providing peace of mind to themselves and clarity to their loved ones and healthcare providers. The North Carolina Living Will is thus an essential tool for anyone looking to have a say in their end-of-life care, safeguarding their autonomy and ensuring that their final days are spent in the manner they deem fit.

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North Carolina Living Will

This Living Will is designed to reflect the wishes of the undersigned, or the Principal, regarding their medical treatment preferences in circumstances where they are no longer able to communicate their decisions due to incapacity. It is created in accordance with the North Carolina General Statutes, Article 23 - Right to Natural Death; Life-Prolonging Measures.

Principal Information

Full Name: ____________________________________________

Date of Birth: _________________________________________

Address: ______________________________________________

City: ______________________ State: NC Zip: ___________

Phone Number: _________________________________________

Declaration

I, _____________________________, being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and I declare:

  1. If at any time I should have an incurable or irreversible condition that will cause my death within a relatively short time, and I am no longer able to make decisions regarding my medical treatment, I direct that my health care providers withhold or withdraw treatment that only prolongs the dying process and is not necessary to my comfort or to alleviate pain.
  2. I desire that my life not be prolonged by life-prolonging measures if my condition is terminal and incurable or if I am in a persistent vegetative state. I further direct that treatment be limited to measures needed to maintain my comfort and relieve pain, including any pain that might result from the lack of treatment.
  3. In the absence of my ability to give directions regarding the use of life-prolonging measures, it is my intention that this directive shall be honored by my family and physicians as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences of such refusal.
  4. I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration.

Signatures

Signature of Principal: _______________________________ Date: ____________

State of North Carolina
County of ________________________

This document was acknowledged before me on (date) ______________ by (name of principal) ________________________________.

Signature of Notary Public: ____________________________

Name of Notary: _______________________________________ Printed

My commission expires: ____________

Witnesses

First Witness Signature: _______________________________ Date: ____________

Print Name: ___________________________________________

Second Witness Signature: _____________________________ Date: ____________

Print Name: ___________________________________________

Special Directives or Limitations

(Here, you may include any specific directives or limitations concerning your health care that you wish to have followed. This section can address concerns such as preferences for hospice care, organ donation preferences, and whether you would prefer to die at home, if possible. Use additional sheets if necessary.)

_________________________________________________________________________

_________________________________________________________________________

This document reflects the wishes of the Principal with respect to their medical treatment at a time when they may no longer be able to communicate their wishes themselves. It is recommended that this document be reviewed periodically to ensure that it continues to reflect your current desires.

PDF Specifications

Fact Number Detail
1 The North Carolina Living Will is legally known as an "Advance Directive for a Natural Death".
2 It allows individuals to state their wishes about medical treatment should they become terminally ill, in a coma, or seriously injured and unable to communicate.
3 Governing law for the form includes the North Carolina General Statutes, specifically Chapter 90, Article 23.
4 People must be at least 18 years old or legally emancipated to create a valid Living Will in North Carolina.
5 The document needs to be signed in the presence of two qualified witnesses and notarized to be legal.
6 Witnesses cannot be related by blood or marriage to the person creating the Living Will and cannot stand to gain financially from the person’s death.
7 Once completed, the Living Will goes into effect when a physician declares the person cannot make medical decisions for themselves.
8 It can be revoked at any time by the creator through a written, dated statement, destruction of the document, or orally during a visit to the doctor.
9 A Living Will is different from a Health Care Power of Attorney, which appoints someone to make medical decisions on the person’s behalf.
10 It is recommended to discuss your Living Will with your family and primary physician and to provide copies to them and any health care agents named.

North Carolina Living Will: Usage Guidelines

A living will is a crucial document for anyone wanting to have a say in their medical treatment should they become unable to communicate their wishes. In North Carolina, completing a living will allow individuals to outline their preferences regarding life-prolonging measures. The process requires careful consideration but following these steps can make it more manageable.

  1. Begin by collecting all necessary personal information, including your full legal name, address, date of birth, and social security number.
  2. Read through the entire form to familiarize yourself with its sections and what each requires. This ensures you understand the implications of your choices.
  3. In the designated section, clearly print your personal information, including your name and address.
  4. Review the options regarding life-prolonging measures. These typically include choices about receiving artificial nutrition and hydration, and instructions for situations where recovery is unlikely.
  5. Mark your choices regarding life-prolonging measures. It's imperative to be as clear as possible to ensure your wishes are understood.
  6. If you have specific wishes about organ donation, make sure to include that information in the indicated section.
  7. Appoint a health care power of attorney, if you choose. This person will make health care decisions on your behalf if you are unable. Provide their full name, address, and a reliable contact number.
  8. Sign the form in the presence of two qualified witnesses. These witnesses must also sign, affirming they believe you to be of sound mind.
  9. In North Carolina, notarization is not mandatory but is recommended to add an extra layer of legal certainty. If you opt for notarization, ensure the notary public signs and seals the form.

After completing these steps, make several copies of the signed document. Keep the original in a safe, accessible place, and provide copies to your appointed health care power of attorney, close family members, and your primary care physician. By doing so, you'll help ensure your wishes are respected and can provide peace of mind to yourself and your loved ones.

Listed Questions and Answers

What is a North Carolina Living Will?

A North Carolina Living Will is a legal document allowing an individual to outline their preferences regarding medical treatment in the event they become incapacitated and unable to express their wishes. It specifically addresses scenarios where the individual is terminally ill, in a persistent vegetative state, or otherwise faces an end-of-life situation. This document enables one to make decisions about life-prolonging measures.

Who should have a Living Will in North Carolina?

Any adult in North Carolina who wishes to have control over their medical treatment should they become incapacitated should consider creating a Living Will. It's especially important for those with strong preferences concerning end-of-life care or specific medical interventions, as well as for individuals with chronic illnesses or terminal conditions.

How can someone create a Living Will in North Carolina?

To create a Living Will in North Carolina, an individual needs to:

  1. Complete the Living Will form, officially known as an "Advance Directive for a Natural Death."
  2. Ensure the form includes their specific wishes about life-sustaining treatments.
  3. Have the document witnessed by two qualified individuals who are not related to them by blood or marriage and who would not inherit from their estate.
  4. Have their signature notarized by a notary public.
Once properly executed, this document becomes legally binding.

What decisions can be made with a North Carolina Living Will?

With a North Carolina Living Will, an individual can make decisions including, but not limited to:

  • Whether to receive life-prolonging measures such as mechanical ventilation, artificial nutrition, and hydration, if they are in a terminal condition or persistent vegetative state.
  • Preferences for pain management and comfort care.
  • Selection of a health care power of attorney to make decisions on their behalf if they haven't already done so in a separate document.

Can a Living Will be changed or revoked in North Carolina?

Yes, a Living Will in North Carolina can be changed or revoked at any time by the person who created it, as long as they are competent. This can be done by:

  • Creating a new Living Will that states the previous one is revoked.
  • Physically destroying the original document.
  • Making a written revocation.
  • Verbally expressing the intent to revoke the document in the presence of a witness who is 18 years of age or older.
It is crucial to communicate any changes or revocation to health care providers and anyone else who was given a copy of the original document.

Is a Living Will from another state valid in North Carolina?

Living Wills executed in other states are generally recognized in North Carolina, provided they were created in compliance with the law of that state or in conformity with North Carolina law. However, it's wise to consult with a legal professional or create a new Living Will under North Carolina law to ensure wishes are clearly understood and enforceable within the state.

Common mistakes

In North Carolina, a Living Will is a legal document that allows you to state your wishes concerning medical treatments and life-prolonging measures in case you become unable to communicate your decisions due to illness or incapacity. While filling out this form, people often make mistakes that can impact its validity or the execution of their wishes. It's crucial to complete it correctly to ensure that your healthcare preferences are honored. Here are five common mistakes:

  1. Not having the document witnessed or notarized correctly. In North Carolina, a Living Will must be signed in the presence of two qualified witnesses and notarized. A common mistake is overlooking the strict requirements about who can serve as a witness. For instance, witnesses cannot be relatives by blood or marriage, beneficiaries of the will, or healthcare providers involved in your care.

  2. Failing to discuss your wishes with the appointed healthcare agent or family. Even though a Living Will speaks for you when you cannot, not talking about your wishes with your healthcare agent or family members can lead to confusion or disputes. Clear communication ensures that everyone understands and respects your healthcare preferences.

  3. Being too vague or unclear about medical treatments and life-prolonging measures. If the instructions in a Living Will are not specific, they might be open to interpretation. This lack of clarity can hinder healthcare providers from making decisions that align with your intentions. Being specific about your wishes regarding artificial nutrition, hydration, and other life-prolonging measures is essential.

  4. Forgetting to update the document after major life changes. A Living Will should reflect your current healthcare wishes. Significant events such as marriage, divorce, the birth of a child, or a change in health condition necessitate a review and, possibly, revisions to your Living Will to ensure it still represents your desires.

  5. Not providing copies to the right people. After completing a Living Will, a mistake some people make is not distributing copies to key individuals. It's important to give copies to your healthcare agent, family members who might be involved in decision-making, and your healthcare providers to make sure your wishes are readily accessible when needed.

Avoiding these mistakes can help ensure that your North Carolina Living Will is effective and clearly communicates your wishes regarding healthcare treatments should you be unable to make such decisions yourself.

Documents used along the form

In North Carolina, the Living Will is an important document that allows an individual to express their wishes regarding medical treatment and end-of-life care. Often, when preparing a Living Will, several other documents are also considered to ensure comprehensive healthcare planning. These documents work together to provide a clear directive regarding an individual's healthcare preferences and other important considerations.

  • Health Care Power of Attorney: This document designates another person as the decision-maker regarding healthcare decisions for the individual, should they become unable to make these decisions themselves. It complements the Living Will by covering decisions not specified in the Living Will.
  • Durable Power of Attorney: This legal form allows an individual to appoint another person to make financial and legal decisions on their behalf, not limited to healthcare. Its effectiveness can extend to various aspects of the individual’s personal and financial affairs.
  • Medical Orders for Scope of Treatment (MOST): A doctor completes this form in consultation with the patient. It covers more detailed healthcare decisions such as the use of antibiotics, feeding tubes, and other life-prolonging measures. It is primarily for those with serious health conditions or the elderly.
  • Do Not Resuscitate (DNR) Order: This is a medical order, signed by a physician, indicating that in the event of a cardiac or respiratory arrest, no resuscitative measures should be employed to revive the patient.
  • Organ and Tissue Donation Registration: This document records an individual's consent to donate their organs and tissues after death. It's an important addition for those who want to contribute to saving lives even after they're gone.
  • Declaration of Anatomical Gift: Similar to the organ and tissue donation registration, this legal document allows individuals to specify donations of organs, eyes, and tissues for transplantation after death. It can either be registered through the state registry or indicated on a driver’s license.
  • Estate Planning Will: While not directly related to healthcare decisions, an estate planning will is crucial for specifying how an individual’s property and affairs should be handled after their passing. It ensures that personal and financial matters are resolved according to the individual's wishes.

Together, these documents create a comprehensive approach to end-of-life planning, addressing not just healthcare directives but also the handling of one’s legal and financial affairs. Individuals are encouraged to consult with legal professionals to accurately complete these forms according to their personal wishes and to ensure they are legally valid and enforceable in North Carolina.

Similar forms

The North Carolina Living Will, formally known as an Advance Directive for a Natural Death, closely resembles the Medical Power of Attorney. Both documents allow individuals to outline their healthcare preferences. However, the Medical Power of Attorney goes a step further by designating another person, known as the healthcare agent, to make decisions on their behalf when they are unable to do so themselves. This appointed agent can make a broad range of decisions, not limited to end-of-life care, based on the directives provided.

Similar to the Health Care Proxy, the North Carolina Living Will enables an individual to dictate their medical care preferences in advance. While the Living Will focuses on scenarios of terminal illness or incapacity, typically detailing wishes regarding life-prolonging treatments or interventions, a Health Care Proxy specifically appoints someone to speak for the person when they can't communicate their wishes, covering a broader range of medical situations beyond those considered terminal or irreversible.

The POLST (Physician Orders for Life-Sustaining Treatment) form also shares common ground with the North Carolina Living Will, as both documents guide medical care based on the patient's preferences. The POLST form is more immediately actionable, being designed for individuals with serious health conditions — it translates their treatment preferences into doctor's orders, readily accessible to healthcare professionals. In contrast, a Living Will generally outlines preferences in less immediate, more hypothetical situations.

The Durable Power of Attorney for Finances is akin to the Medical Power of Attorney aspect of healthcare planning but addresses financial decisions instead of health-related ones. Like the healthcare counterpart, it designates someone to manage the personal financial affairs of an individual who becomes incapacitated. While distinctly different in content, both documents are preventive steps to ensure chosen representatives can act when the individual cannot.

The Do Not Resuscitate (DNR) Order has specific similarities with a Living Will as both relate to end-of-life decisions. A DNR is a doctor's order that tells medical personnel not to perform CPR if breathing or heart stops. In contrast, a Living Will may address a broader array of interventions one may or may not want in a terminal condition. However, both documents share the intent of directing medical care according to the individual's wishes.

An Advance Directive in other states often functions similarly to the North Carolina Living Will. Advance Directives are legal documents that communicate a person’s wishes about medical treatment if they are unable to make decisions due to illness or incapacity. Though the specifics can vary by state, the foundational purpose—to guide healthcare decisions when the individual is not able to communicate—remains consistent throughout the United States.

The Five Wishes Document intersects with the purpose and content of a Living Will but adds layers of personal, emotional, and spiritual wishes alongside the medical and legal aspects. This document acts as a comprehensive guide for families and healthcare providers, covering aspects like the type of medical treatment the individual desires, how comfortable they want to be, how they wish to be treated by others, and what they want their loved ones to know.

A Will or Testament, while primarily focused on dictating the distribution of an individual's estate after death, shares the anticipatory nature of a Living Will. However, its concern is with assets and guardianship rather than healthcare preferences. Both documents require thoughtful consideration of the future and legally record one's wishes to guide actions on their behalf when they are no longer able to articulate those desires themselves.

The Mental Health Advance Directive is specific to psychiatric care, allowing individuals to outline their preferences for treatment in the event of mental health crises. Like the Living Will, it’s a tool for planning ahead, but it specifically addresses psychiatric interventions, medications, hospitalization preferences, and even choices about emergency contacts and communications with healthcare professionals and loved ones regarding one's care.

Dos and Don'ts

In North Carolina, a Living Will is a legal document that outlines your wishes regarding medical treatment if you become unable to communicate or make decisions. When filling out this important form, there are several dos and don'ts to keep in mind to ensure your wishes are properly documented and respected.

Things You Should Do

  • Read the entire form carefully before you start filling it out to understand the scope of decisions you need to make.
  • Be clear and specific about your medical treatment preferences, especially regarding life-prolonging measures, artificial nutrition, and hydration.
  • Discuss your decisions with your family, close friends, and healthcare providers to ensure they understand your wishes and the reasons behind them.
  • Have the form notarized or witnessed as required by North Carolina law to ensure it is legally binding. Pay close attention to the state’s specific requirements regarding witnesses.
  • Keep the original document in a safe but accessible place, and inform your healthcare power of attorney (if you have one), family members, and primary care physician of its location.
  • Review and update your Living Will periodically or after major life changes, such as a diagnosis of a serious illness, the death of a loved one, or a change in marital status.

Things You Shouldn't Do

  • Don’t fill out the form in haste. Take your time to consider your choices thoroughly.
  • Avoid using vague language that could be open to interpretation. Be as specific as possible to prevent ambiguity about your wishes.
  • Don’t leave any sections incomplete. If a section doesn't apply to your situation, indicate this clearly to prevent confusion later.
  • Refrain from signing the document without the required witnesses or notarization, as this could render the document invalid.
  • Do not forget to communicate your wishes and the existence of your Living Will to those who need to know, such as your healthcare proxy, family members, and medical providers.
  • Avoid failing to keep your Living Will updated. An outdated document may not reflect your current wishes and could lead to unnecessary confusion and distress for your loved ones.

Correctly completing your North Carolina Living Will is a proactive step in managing your healthcare preferences and ensuring your wishes are followed in the future. By paying attention to these dos and don'ts, you can provide clear guidance to your loved ones and healthcare providers, potentially easing difficult decisions during challenging times.

Misconceptions

When considering the creation of a Living Will in North Carolina, it's important to navigate through common misconceptions that may influence your decisions. Understanding these misconceptions ensures that your healthcare wishes are clearly documented and respected.

  • A Living Will is the same as a Last Will and Testament. Unlike a Last Will and Testament which outlines how to distribute your property after death, a Living Will details your healthcare preferences if you're unable to communicate.

  • You only need a Living Will if you are elderly or have a terminal illness. Anyone over the age of 18 can benefit from a Living Will. Accidents or sudden illness can happen at any age, making it vital to have plans in place.

  • Doctors won't try as hard to save you if you have a Living Will. Healthcare providers are committed to saving lives. A Living Will activates only under specific conditions you've outlined when you cannot make decisions yourself.

  • Creating a Living Will is a complicated and expensive process. In North Carolina, creating a Living Will can be straightforward. Forms are available that simplify expressing your healthcare wishes without the necessity of a lawyer, although consulting one can be beneficial.

  • A Living Will is only used if you are in a coma. While comas are one scenario where Living Wills apply, they also cover situations where you may be terminally ill or permanently unconscious with no hope of recovery.

  • If you change your mind, it's difficult to modify your Living Will. You can change or revoke your Living Will at any time as long as you are competent to do so. You should then communicate these changes to anyone who has a copy of the old document.

  • Living Wills are only for end-of-life decisions. While they are often associated with end-of-life care, Living Wills can also specify wishes for other critical medical conditions or treatments.

  • Your family can easily override your Living Will. In North Carolina, a Living Will is legally binding. Healthcare providers must follow it, and family members cannot override your expressed wishes unless the Living Will allows for such discretion.

  • Having a durable power of attorney for healthcare makes a Living Will unnecessary. While both documents are important, they serve different purposes. A durable power of attorney for healthcare appoints someone to make decisions on your behalf, whereas a Living Will communicates your wishes directly to healthcare providers.

Dispelling these misconceptions helps in recognizing the importance and benefits of a Living Will, ensuring that your healthcare preferences are respected, regardless of your health status or age.

Key takeaways

Understanding and completing a Living Will in North Carolina requires careful attention to details and a thoughtful reflection on one’s wishes regarding end-of-life care. Whether you're considering putting your wishes on paper for the first time or revisiting your decisions, here are some key takeaways about the process.

  • A North Carolina Living Will, also known as an "Advance Directive for a Natural Death," legally records your wishes about life-prolonging measures in the event that you become terminally ill, permanently unconscious, or otherwise unable to communicate.
  • It's vital to have open discussions with your family, loved ones, and healthcare providers about your preferences for end-of-life care before you finalize and sign the document. This ensures that your wishes are understood and respected.
  • To complete a Living Will in North Carolina, you must be at least 18 years old and of sound mind at the time of the document’s creation.
  • Your Living Will becomes effective only under specific medical conditions, such as a terminal illness or permanent unconsciousness, as certified by one or more physicians.
  • The document needs to be witnessed by two individuals and notarized to be legally binding. Note that there are specific restrictions on who can act as a witness, thereby ensuring an unbiased process.
  • While a lawyer is not required to draft a Living Will in North Carolina, consulting with a healthcare attorney can provide valuable insight and ensure that the document accurately reflects your wishes and complies with state law.
  • Once completed, creating copies of your Living Will and distributing them to key people, such as your healthcare power of attorney, family members, and your doctor, helps ensure your wishes are honored.
  • It's important to review and possibly update your Living Will periodically, especially after significant life events like marriage, divorce, the birth of a child, or a major change in health status. This helps keep the document in line with your current wishes and circumstances.

Filling out and properly using a North Carolina Living Will is a profound step in taking control of your healthcare decisions and ensuring your end-of-life wishes are respected. By following these key points, you can approach this sensitive process with confidence and clarity.

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