North Carolina statutes grant you the right to require that your wishes be honored if you are at the end-of-life stage rather than permitting them to be followed. In your Health Care Power of Attorney and Advance Directive, you may direct the administration or withholding of artificial nutrition and/or artificial hydration, and specify that treatment (“life-prolonging measures”) shall or may be withheld when any, some, or all of the following conditions exist:

  • You have an incurable or irreversible condition that will result in your death within a relatively short period of time; or
  • You become unconscious and, to a high degree of medical certainty, will never regain consciousness; or
  • You suffer from advanced dementia or any other condition resulting in the substantial loss of cognitive ability and that loss, to a high degree of medical certainty, is not reversible.

“Life-prolonging procedures” is defined as:

Medical procedures or interventions which in the judgment of the attending 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.

Although as a practical matter, the attending physician has the discretion to determine when the conditions have or have not been met, once the conditions have been satisfied, an attending physician will be able to rely on “shall” when family members have different views than those expressed in your Health Care Power of Attorney and Advance Directive. On the other hand, “shall” will provide family members with some leverage when an attending physician is vacillating regarding your particular medical condition. 

A health care agent may be authorized to make certain post-mortem decisions on your behalf if you have not made these decisions for yourself prior to your death. You may grant or withhold from your health care agent the power to (1) authorize an autopsy, (2) consent to donation of your tissue or organs for transplantation or therapy, (3) donate your body for anatomical study, and (4) direct the disposition of your remains—whether your body is buried or cremated.

The statutes do not address differing cultural and religious values in our society. Health care powers of attorney and advance directives provide the flexibility to tailor the documents to your particular desires and wishes. You may also address mental health treatments and resuscitation (a DNR order).     

A copy of your health care power of attorney and advance directive should be given to your primary physician for placement in your medical file. In addition, you should provide a copy to your designated health care agent and place your documents in an easily accessible place at your home. 

The burden of making our end-of-life decisions should not be left to our family or the courts. Because the law grants us the right to make these decisions for ourselves, we need to exercise our right to self-direct rather than leaving the burden to others.