Advance Directives in South Carolina: Living Will & Healthcare Power of Attorney

What Are Advance Directives?

Advance directives are legal documents that allow you to make your healthcare wishes known in advance, in case you ever become unable to speak for yourself due to illness, injury, or dementia. These documents give you control over your medical care and relieve your loved ones of the burden of guessing what you would want during a crisis.

Many people assume that advance directives are only for older adults, but that is not true. Unexpected accidents and serious illnesses can happen at any age. Every adult in South Carolina should consider completing an advance directive, regardless of age or current health status. The peace of mind that comes from having these conversations and documents in place is invaluable for both you and your family.

At Midlands Aging & Disability Resource Connection, we believe that advance care planning is a fundamental part of aging with dignity and autonomy. Our Advance Directives & Legal Assistance program provides free education, forms, and guidance to residents of Fairfield, Lexington, Newberry, and Richland Counties. We do not provide legal advice, but we can help you understand your options, obtain the correct forms, and think through the decisions that matter most to you.

The South Carolina Living Will

A living will is a document that states your wishes about medical treatments you would want or not want if you are terminally ill, have an end-stage condition, or are in a persistent vegetative state with no reasonable chance of recovery. It specifically addresses life-prolonging procedures such as mechanical ventilation, artificial nutrition and hydration, and resuscitation.

In South Carolina, the living will becomes effective only when a physician determines that you have a terminal condition or are in a persistent vegetative state, and you are unable to communicate your wishes. Until that point, your healthcare providers will continue to seek your direct input. This means that signing a living will does not prevent you from receiving treatment for curable conditions.

The South Carolina living will form includes options to accept or refuse specific treatments. You can also add personal instructions about pain management, comfort care, and organ donation. The more specific you are, the easier it will be for your family and doctors to honor your wishes. Our staff can walk you through each section of the form and explain the implications of each choice.

The Healthcare Power of Attorney

A healthcare power of attorney, sometimes called a healthcare proxy or durable power of attorney for healthcare, is a document that names another person, called your agent or attorney-in-fact, to make medical decisions on your behalf if you are unable to do so. Unlike a living will, which only covers end-of-life situations, a healthcare power of attorney applies to any medical decision whenever you lack capacity.

Choosing your healthcare agent is one of the most important decisions you will make. Your agent should be someone you trust completely, who understands your values, and who is willing to advocate for your wishes even if they differ from their own beliefs or preferences. You should have an honest conversation with this person before naming them, making sure they understand your priorities and are comfortable carrying out your wishes.

You can name a primary agent and one or more alternate agents in case your first choice is unavailable. You can also include specific instructions about the types of decisions your agent is authorized to make. Some people give their agent broad authority, while others limit it to certain situations. South Carolina law allows you to customize these powers within the statutory form.

Other Important Documents

In addition to a living will and healthcare power of attorney, South Carolina residents may want to consider several related documents as part of a comprehensive advance care plan.

Do Not Resuscitate (DNR) Order

A DNR order is a medical order, not a legal document, that tells emergency medical personnel not to perform cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing. DNR orders must be issued by a physician and are typically used by individuals with terminal conditions who do not want aggressive life-saving measures.

Physician Orders for Life-Sustaining Treatment (POLST)

While not yet universally adopted in all settings across South Carolina, POLST forms are increasingly recognized. These are portable medical orders that translate your treatment preferences into actionable instructions for emergency personnel and healthcare facilities. Ask your physician whether a POLST is appropriate for your situation.

Organ and Tissue Donation

You can register as an organ donor through the South Carolina Department of Motor Vehicles when you renew your driver's license or directly through organ donor registries. You can also include donation wishes in your living will. Be sure to inform your family of your decision so they can support it.

Legal Requirements in SC

To be legally valid in South Carolina, both the living will and the healthcare power of attorney must meet specific requirements outlined in state law.

• Capacity: You must be at least 18 years old and of sound mind when you sign the document.
• Witnesses: The document must be signed in the presence of two adult witnesses.
• Notary: The document must also be notarized. The notary can serve as one of the witnesses if they are not named as an agent in the document.
• Restrictions on witnesses: Your healthcare agent, your attending physician, and employees of your healthcare provider generally cannot serve as witnesses.

Once completed, you should keep the original in a safe but accessible place. Provide copies to your healthcare agent, your primary care physician, any specialists you see regularly, and family members who may be involved in your care. Some hospitals and healthcare systems also allow you to upload advance directives to your electronic medical record.

How to Complete Your Advance Directive

Completing an advance directive may feel overwhelming, but breaking it into steps makes the process manageable. Our staff are here to help you at every stage.

Step 1: Reflect on Your Values

Before filling out any forms, think about what matters most to you. Would you want every possible treatment to extend life, or would you prefer to focus on comfort? Are there medical interventions you definitely want to avoid? How do you feel about being in a hospital versus at home at the end of life? Writing down your thoughts can clarify your preferences.

Step 2: Obtain the Forms

South Carolina statutory forms are available from several sources, including the South Carolina Department of Health and Environmental Control and our office. We can provide you with the current, state-approved living will and healthcare power of attorney forms at no cost.

Step 3: Complete and Execute

Fill out the forms carefully, following the instructions provided. Do not sign them until you are in the presence of your witnesses and a notary public. Our staff can help you locate notary services and explain the witnessing process.

Step 4: Distribute Copies

Give copies to your agent, doctors, family members, and anyone else who might need them. Keep a list of who has copies so you can update them if you make changes later.

Talking with Family and Providers

Advance care planning is not just about paperwork. It is about conversations. The most effective advance directives are supported by clear communication with the people who may one day be called upon to honor your wishes.

Talk to your healthcare agent about what you value, not just what treatments you want. Explain why certain choices matter to you. Share examples from your own life, your faith, or your observations of others' experiences. The more context your agent has, the better equipped they will be to make decisions in situations the forms do not specifically address.

It is also helpful to discuss your wishes with your primary care physician. Doctors appreciate knowing their patients' preferences, and they can help you understand the medical realities behind certain choices. If you have a serious or chronic condition, these conversations are especially important.

Changing or Revoking Your Directive

Your advance directive is not set in stone. You can revoke or amend it at any time as long as you are mentally competent. The best way to make changes is to create a new document, clearly state that it revokes all previous versions, and redistribute copies to everyone who held the old one.

Life changes such as marriage, divorce, the death of your agent, a new diagnosis, or a shift in your personal beliefs may prompt you to revisit your advance directive. We recommend reviewing your documents every few years even if nothing major has changed, just to confirm they still reflect your wishes.

Frequently Asked Questions