§ 122C-74. Effectiveness and duration; revocation. - North Carolina Statutes

§ 122C‑74. Effectiveness and duration; revocation.

(a)        A validly executedadvance instruction becomes effective upon its proper execution and remainsvalid unless revoked.

(b)        The attendingphysician or other mental health treatment provider may consider valid and relyupon an advance instruction, or a copy of that advance instruction that isobtained from the Advance Health Care Directive Registry maintained by theSecretary of State pursuant to Article 21 of Chapter 130A of the GeneralStatutes, in the absence of actual knowledge of its revocation or invalidity.

(c)        An attendingphysician or other mental health treatment provider may presume that a personwho executed an advance instruction in accordance with this Part was of soundmind and acted voluntarily when he or she executed the advance instruction.

(d)        An attendingphysician or other mental health treatment provider shall act in accordancewith an advance instruction when the principal has been determined to beincapable. If a patient is incapable, an advance instruction executed inaccordance with this Article is presumed to be valid.

(e)        The attendingphysician or mental health treatment provider shall continue to obtain theprincipal's informed consent to all mental health treatment decisions when theprincipal is capable of providing informed consent or refusal, as required byG.S. 122C‑57. Unless the principal is deemed incapable by the attendingphysician or eligible psychologist, the instructions of the principal at thetime of treatment shall supersede the declarations expressed in the principal'sadvance instruction.

(f)         The fact of aprincipal's having executed an advance instruction shall not be considered anindication of a principal's capacity to make or communicate mental healthtreatment decisions at such times as those decisions are required.

(g)        Upon beingpresented with an advance instruction, an attending physician or other mentalhealth treatment provider shall make the advance instruction a part of theprincipal's medical record. When acting under authority of an advanceinstruction, an attending physician or other mental health treatment providershall comply with the advance instruction unless:

(1)        Compliance, in theopinion of the attending physician or other mental health treatment provider,is not consistent with generally accepted community practice standards oftreatment to benefit the principal;

(2)        Compliance is notconsistent with the availability of treatments requested;

(3)        Compliance is notconsistent with applicable law;

(4)        The principal iscommitted to a 24‑hour facility pursuant to Article 5 of Chapter 122C ofthe General Statutes, and treatment is authorized in compliance with G.S. 122C‑57and rules adopted pursuant to it; or

(5)        Compliance, in theopinion of the attending physician or other mental health treatment provider,is not consistent with appropriate treatment in case of an emergencyendangering life or health.

In the event that one part of theadvance instruction is unable to be followed because of one or more of theabove, all other parts of the advance instruction shall nonetheless befollowed.

(h)        If the attendingphysician or other mental health treatment provider is unwilling at any time tocomply with any part or parts of an advance instruction for one or more of thereasons set out in subdivisions (1) through (5) of subsection (g), theattending physician or other mental health care treatment provider shallpromptly notify the principal and, if applicable, the health care agent andshall document the reason for not complying with the advance instruction andshall document the notification in the principal's medical record.

(i)         An advanceinstruction does not limit any authority provided in Article 5 of G.S. 122Ceither to take a person into custody, or to admit, retain, or treat a person ina facility.

(j)         An advanceinstruction may be revoked at any time by the principal so long as theprincipal is not incapable. The principal may exercise this right of revocationin any manner by which the principal is able to communicate an intent to revokeand by notifying the revocation to the treating physician or other mentalhealth treatment provider. The attending physician or other mental healthtreatment provider shall note the revocation as part of the principal's medicalrecord. (1997‑442,s. 2; 1998‑198, s. 2; 2001‑455, s. 5; 2001‑513, s. 30(b).)