Shared Decision Making

Advance Directives

What kind of medical care would you want if you were too ill or hurt to express your wishes? Advance directives are legal documents that allow you to convey your decisions about end of life care long before there is a medical crisis. They provide a way for you to communicate your wishes to family, friends and health care professionals, and to avoid confusion later on. These directives go into effect only when you cannot make health care decisions for yourself. Advance care planning is the process where you explore your values about your health care, talk with your loved ones and health care providers about your wishes, and record your wishes.
 
The South Carolina Hospital Association joined with the Carolinas Center for Hospice and End of Life Care, the South Carolina Medical Association, and the South Carolina Bar Association to develop two documents on advance care planning to help the public and health care professionals: “Isn’t It Time We Talk” brochure and Frequently Asked Questions about advance directives. Both of these documents can be downloaded from the resource list located on this page.

You can also access the South Carolina Health Care Power of Attorney and Living Will form in both English and Spanish at the website links below.

Health Care Power of Attorney

A durable power of attorney for health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions if you are unable to do so.
 
Health Care Power of Attorney Form in English
 
Health Care Power of Attorney Form in Spanish

SC Health Care Power of Attorney legislation

SC Living Will or “Declaration of a Desire for a Natural Death” under the SC Death with Dignity Act

A living will tells how you feel about care intended to sustain life. You can accept or refuse medical care. There are many issues to address, including tube feeding, dialysis, organ donation and breathing machines.
 
SC Living Will Form in English

 
SC Living Will Form in Spanish

SC Living Will legislation

SC Adult Health Care Consent Act

If you do not have an advance directive, the SC Adult Health Care Consent Act lists the order of priority of persons who may make health care decisions for a patient who is unable to consent.

SC Emergency Medical Services (EMS) Do Not Resuscitate (DNR) Form

Physicians must request the SC Emergency Medical Services (EMS) Do Not Resuscitate (DNR) Form  which allows EMS personnel to honor written DNR orders on an adult patient who is terminally ill. Talk with your physician if you want more information, and ask him or her to call DHEC EMS office at (803) 545-4204 to request this form.

SC Coalition for the Care of the Seriously Ill 

This statewide coalition brings key organizations, clinicians, and healthcare entities together to collaboratively  redesign care, improve quality of life, and protect the ethical rights of the seriously, chronically, or terminally ill in South Carolina. The coalition is committed to improving the shared decision-making for this population by implementing strategies which help patients understand the typical trajectory of their condition and take an active role in their treatment, including decisions about their care.

The coalition is examining the feasibility of implementing the national POLST (Physician Orders for Life-Sustaining Treatment) Paradigm http://www.ohsu.edu/polst/ in our state so that patient directives  can more easily be followed. Legislation would be required. The coalition is also developing a manual and toolkit to help clinicians and healthcare facilities understand the ethical issues involved in chronic, serious, and terminal illnesses, provide palliative care for patients in all settings, and ensure that the patient has an active voice in the care decision process.

Members of the Coalition include the South Carolina Medical Association, The Carolinas Center for Hospice and End of Life Care, the South Carolina Hospital Association, the SC Healthcare Ethics Network, The S.C. Society of Chaplains, LifePoint, AARP, and the South Carolina Nurses Association.


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