North Carolina Statutory Form Health Care Power Of Attorney Page 9
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11F. To give consent for, to withdraw consent for, or to withhold consent for, X ray, anesthesia,
medication, surgery, and all other diagnostic and treatment procedures ordered by or under
the authorization of a licensed physician, dentist, or podiatrist (This authorization specifically
includes the power to consent to measures for relief of pain);
G. To authorize the withholding or withdrawal of life-sustaining procedures when and if the
principal’s physician determines that he or she is terminally ill, permanently in a coma,
suffers severe dementia, or is in a persistent vegetative state (Life-sustaining procedures are
those forms of medical care that only serve to artificially prolong the dying process and may
include mechanical ventilation, dialysis, antibiotics, artificial nutrition and hydration, and
other forms of medical treatment which sustain, restore or supplant vital bodily functions.
Life-sustaining procedures do not include care necessary to provide comfort or alleviate pain);
H. To exercise any right the principal may have to make a disposition of any part or all of his
or her body for medical purposes, to donate the principal’s organs, to authorize an autopsy,
and to direct the disposition of the principal’s remains; and
I. To take any lawful actions that may be necessary to carry out these decisions, including the
granting of releases of liability to medical providers.
6. Explain the contents of Section 4 (“Special provisions and limitations”) in “Exhibit C:
Health Care Power of Attorney.”
Exhibit C, Section 4 allows the principal to limit, by specifying restrictions to, the scope of the
health care agent’s powers, including those related to health care decisions and mental health
decisions.
7. Explain the contents of Section 5 (“Guardianship provision”) in “Exhibit C: Health
Care Power of Attorney.”
Exhibit C, Section 5 empowers the health care agent designated in the health care power of
attorney to act as a legal guardian for the principal.
8. Explain the contents of Section 6 (“Reliance of third parties on health care agent”) in
“Exhibit C: Health Care Power of Attorney.”
Exhibit C, Section 6 disclaims liability for third parties who rely, in good faith, upon the
authority and/or representations of the principal’s health care agent. Section 6 also affirms
the right of the health care agent to act as if the principal were acting on his or her own, with
such actions having the same legal force and effect as if the principal were acting on his or
her own. Finally, Section 6 asserts that the authority of the health care agent, acting pursuant
to the health care power of attorney, shall be “superior to and binding upon” the principal’s
“family, relatives, friends, and others.”
9. Explain the contents of Section 7 (“Miscellaneous provisions”) in “Exhibit C: Health
Care Power of Attorney.”
Exhibit C, Section 7 contains four (4) “miscellaneous” provisions:
9
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal