South Carolina Living Wills & Advance Directives: Secure Your Care

Planning ahead for medical decision-making helps ensure your care follows your wishes if you cannot speak for yourself. South Carolina law provides two primary advance directive tools: a living will (called a Declaration of a Desire for a Natural Death) and a Health Care Power of Attorney (HCPOA). These laws include statutory forms, execution rules, and default decision-makers when no directive exists. See S.C. Code Title 44, Ch. 77; S.C. Code Title 62, Art. 5, Pt. 5; and the surrogate decision-making rules in the Adult Health Care Consent Act (Title 44, Ch. 66).

What Is an Advance Directive in South Carolina?

In South Carolina, “advance directives” generally include two key documents: (1) a Declaration of a Desire for a Natural Death (often called a living will), which states your wishes about life-sustaining treatment in specific conditions, and (2) a Health Care Power of Attorney, which appoints an agent to make broader health care decisions if you cannot. See Title 44, Ch. 77; Title 62, Art. 5, Pt. 5.

Living Will (Declaration of a Desire for a Natural Death)

South Carolina’s living will is created by statute and allows you to accept or refuse life-sustaining procedures in limited circumstances—typically when you are terminally ill or permanently unconscious and cannot communicate your wishes. You may also address artificial nutrition and hydration and affirm the availability of comfort care and pain relief. The declaration takes effect only when the statutory conditions are met. See Title 44, Ch. 77 (including form, definitions, execution, effect, and revocation).

Health Care Power of Attorney

A South Carolina Health Care Power of Attorney lets you name an agent to make health care decisions when you lack capacity. Your agent’s authority is broad but must follow your stated wishes and any limits in the document and law. The Probate Code includes a statutory HCPOA form and execution requirements. See Title 62, Art. 5, Pt. 5 (including statutory form and execution requirements).

Who Can Create These Documents?

Generally, any competent adult may execute a living will and an HCPOA. Capacity means you understand the nature of the documents and the decisions they cover. If there are concerns about capacity, consult your clinician and attorney before signing. See Title 44, Ch. 77; Title 62, Art. 5, Pt. 5.

Execution and Witnessing Requirements

South Carolina law sets specific formalities for validity. Both the living will and HCPOA must be signed and witnessed by two qualified adult witnesses. Certain individuals generally may not serve as witnesses (for example, some close relatives, the attending physician, certain facility staff, and—if signing an HCPOA—the named agent). Using the statutory forms and following the witness restrictions helps ensure your documents are honored. See Title 44, Ch. 77 (living will execution and witness qualifications); Title 62, Art. 5, Pt. 5 (HCPOA execution and witness disqualifications).

When Do These Directives Take Effect?

• Living will: Applies only in the circumstances defined by statute (e.g., terminal condition or permanent unconsciousness) and when you cannot communicate. See Title 44, Ch. 77.
• Health Care Power of Attorney: Becomes effective when your attending physician determines you lack capacity to make health care decisions. If you regain capacity, you resume decision-making. See Title 62, Art. 5, Pt. 5.

What If There’s No Advance Directive?

If you have not executed an advance directive and cannot make decisions, South Carolina’s Adult Health Care Consent Act provides a priority list of potential decision-makers (a surrogate hierarchy), which includes, in order, persons such as a court-appointed guardian, your spouse, adult children, parents, adult siblings, and others. See S.C. Code § 44-66-30.

Revocation and Changes

You may revoke or update your living will and HCPOA at any time while you have capacity. Revocation can be accomplished in the manner provided by statute and the forms. If you revise your documents, notify your health care providers and replace prior copies so your current wishes are followed. See Title 44, Ch. 77 (revocation of declaration); Title 62, Art. 5, Pt. 5 (HCPOA revocation).

Portability and Recognition

South Carolina generally recognizes advance directives validly executed in another state if they are consistent with South Carolina public policy. If you spend significant time in another state, consider executing that state’s form to avoid delays. See Title 62, Art. 5, Pt. 5 (HCPOA recognition); Title 44, Ch. 77 (living will recognition).

Practical Steps to Put Your Plan in Place

• Use South Carolina’s statutory forms or forms that closely track the statutory language (living will; HCPOA).
• Follow witness eligibility rules and execution instructions exactly.
• Discuss your preferences with your agent, alternates, family, and clinicians.
• Provide copies to your agent, alternates, primary care provider, specialists, and preferred hospital.
• Keep a copy accessible and carry an agent card or note in your phone with your agent’s contact information.
• Review after major life changes, diagnoses, or annually to confirm your wishes.

Special Topics: Pregnancy, Pain Management, and DNR Orders

South Carolina law addresses certain special circumstances, including pregnancy and the availability of comfort care and pain management even when life-sustaining treatment is limited (see Title 44, Ch. 77). Separate physician orders—such as Do Not Resuscitate (DNR) orders for emergency medical services—operate within the medical system and are distinct from your living will and HCPOA. Ask your clinician whether a DNR or portable DNR order is appropriate in your situation. See Title 44, Ch. 78 (EMS DNR Orders).

FAQ

Do I need a notary in South Carolina?

State law requires two qualified witnesses. Notarization is not a substitute for required witnesses unless the statutory form provides otherwise.

Can my health care agent override my living will?

Your living will controls the specific end-of-life choices it covers. Your agent must follow your stated wishes and any limits in your documents and the law.

Will hospitals honor forms from another state?

Generally yes, if consistent with South Carolina public policy, but local forms can avoid delays.

How often should I update my directives?

Review annually and after major life events, new diagnoses, or changes in relationships.

How a Lawyer Can Help

An attorney can tailor your directives to your values, ensure proper execution and witness eligibility, coordinate with your estate plan, and prepare clear guidance for your agent—especially helpful with complex families, multistate living arrangements, or specific medical or religious directives.

Have questions or need help getting your documents in place? Contact our South Carolina team.

References

• South Carolina Code of Laws, Title 44, Chapter 77 (Death With Dignity Act)
• South Carolina Code of Laws, Title 62, Article 5, Part 5 (Health Care Powers of Attorney)
• South Carolina Code of Laws, Title 44, Chapter 66 (Adult Health Care Consent Act)
• South Carolina Code of Laws, Title 44, Chapter 78 (Do Not Resuscitate Orders for Emergency Medical Services)

Last reviewed: 2025-10-10.

Disclaimer (South Carolina): This blog is for general information only, based on South Carolina law as cited, and is not legal advice. Laws change and individual circumstances vary. Consult a licensed South Carolina attorney for advice about your situation.