You have the right to make instructions for your treatment in advance. North Carolina has two laws that govern Psychiatric Advanced Directives (PAD): G.S.122C-71 through 77 and G.S.32A-15 through 25. The PAD or Advanced Directive for Mental Healthcare is a legal document that provides instruction for the mental health treatment you want if you are in a crisis and unable to communicate or make voluntary decisions. The instructions make statements about what calms you, how you feel about seclusion or electric shock, what medicines you do not want to take and which doctor you want in charge of your treatment. These are decisions you make in advance for a physician or psychologist to follow in a crisis. Your instructions can be overridden if you are held in accordance with civil commitment law.
Under the Health Care Power of Attorney (another legal form), you may appoint a person as your health care agent to make treatment decisions for you. The powers granted by this document are broad and sweeping and cannot be made by your doctor or your treatment provider under North Carolina law.
The PAD and Health Care Power of Attorney legal forms were designed by Duke University. Even if you do not wish to file these forms as legal documents, the questions asked will help you plan for a crisis and think about the treatment you would want. Cardinal Innovations' Office of Consumer Affairs can send you the forms and help you consider some of the questions on the form. To reach Consumer Affairs, call the number in your area:
Corporate Office: 704-939-7700
Five County (Franklin, Granville, Halifax, Vance, and Warren counties): 252-430-1330
OPC (Orange, Person, and Chatham counties): 919-913-4000
Piedmont (Cabarrus, Davidson, Rowan, Stanly, and Union counties): 704-721-7000
Triad (Forsyth, Davie Stocks, and Rockingham counties): 336-714-9100
You also can create a Living Will to specify your treatment in a hospital. A Living Will goes into effect when you are unable to share what you want to happen regarding your care or when you are in a persistent vegetative state. A Living Will is a document that tells others that you want to die a natural death if you are incurably sick and cannot receive nutrition or breathe on your own.
The Advanced Directive for Mental Healthcare, the Health Care Power of Attorney and Living Will documents all must be written and signed by you while you are still able to understand your condition and treatment choices, and make your wishes known. Two qualified people must witness all three types of advance directives. The Living Will and the Health Care Power of Attorney also must be notarized.
Keep a copy of these documents in a safe place, and give copies to your family, treatment team, your doctor and the hospital where you are likely to receive treatment. You also can arrange to have your PAD filed in a national database or file your PAD in the North Carolina Advanced Health Care Directive Registry, which is part of the Department of the North Carolina Secretary of State. There is a $10 fee to register a PAD. This includes the registration, a revocation form, registration card and password. You can use the revocation form at any time if you change your mind.
For a user-friendly version of advanced instructions for mental health treatment, you may visit the ARC of NC and look for Advanced Instruction for Mental Health Treatment (AIMHT).
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