South Carolina Healthcare Directive

South Carolina healthcare directive planning is medical decision planning. It helps name who speaks with doctors if the patient cannot consent, records treatment wishes, and keeps medical records accessible when timing matters.

Use this guide as source navigation, not medical guidance, legal help, or a tax opinion. Use South Carolina power of attorney for financial POA authority over money, property, records, and transactions. Use How to avoid probate in South Carolina for beneficiary, trust, title, and asset-record planning.

This page owns the South Carolina health care directive question. It covers health care powers of attorney, living wills, default health care decision makers, and POST form context. It does not cover estate distribution after death or financial agent authority. For a broader planning-document overview, use the estate planning documents guide. For post-death transfer work, use the South Carolina asset-transfer guide.

The Main South Carolina Documents

South Carolina planning uses several different medical decision documents. They are related, but not identical.

Keep these documents in the medical file, not only in the estate file. A signed directive helps only if the agent, physician, hospital, nursing care provider, or facility can find it.

Health Care Power of Attorney

South Carolina Probate Code Article 5, Part 5 is the South Carolina Statutory Health Care Power of Attorney Act. Section 62-5-501 defines a health care power of attorney as a durable power of attorney executed under that part, and defines a health care agent as the person named to make health care decisions for the principal.

Section 62-5-503 says a South Carolina health care power of attorney needs:

• substantial use of the statutory form
• date and principal signature, or a directed signature made in the principal's presence
• at least two witnesses who witnessed the signing or acknowledgment
• witness declarations with the statute's relationship, financial-responsibility, inheritance, insurance, agent, physician, employee, facility, and estate-claim limits
• agent name and address
• an agent who is at least 18 and of sound mind

The same section limits who can serve as agent when the person is a health care provider, provider employee, nursing care facility employee, or spouse of one of those people, unless that person is a relative of the principal.

When the Health Care Agent Acts

Section 62-5-502 says a health care power of attorney is durable. It also ties effectiveness to mental incompetence using the Adult Health Care Consent Act standard for inability to consent, except that the agent's certification may replace a second physician certification.

The statutory form says the health care power of attorney is effective upon, and only during, a period of mental incompetence, except for HIPAA access language in the form. It also says the principal keeps the right to make health care decisions while mentally competent.

For planning, keep a copy with:

• named agent and successor agent contact details
• physician and health system records
• HIPAA and medical-record access notes
• nursing care facility or hospital record, if relevant
• written values, treatment wishes, and religious or personal instructions
• financial POA contact details for nonmedical paperwork

Use South Carolina power of attorney when the file also needs banking, insurance, tax, real-estate, or other financial authority.

Health Care Agent Powers

Section 62-5-505 gives a health care agent powers in addition to the document terms. Those powers include access to medical records and information, contracting for placement in a health care or nursing care facility without personal financial liability for the contract, hiring and firing medical or social-service support personnel, and facility visitation rights similar to immediate family members or spouses.

The South Carolina statutory form also gives broad health care decision authority unless the principal limits it. It includes consent, refusal, or withdrawal of consent for medical care, treatment, surgery, diagnostic procedures, medication, mechanical procedures affecting bodily function, artificial respiration, nutritional support, hydration, and cardiopulmonary resuscitation.

That authority is not a blank check to ignore the principal. Section 62-5-511 says directives, personal values, and statements of intent in the health care power of attorney are exercises of the principal's right to direct health care. Decisions by a guardian, Probate Court, or surrogate under the Adult Health Care Consent Act follow the directions stated in the health care power of attorney.

Living Will or Declaration of Desire for Natural Death

South Carolina's living-will statute is Title 44 Chapter 77, the Death With Dignity Act. The statute calls the document a Declaration of Desire for Natural Death.

Section 44-77-30 says life-sustaining procedures may be withheld or withdrawn when a person age 18 or older has adopted a qualifying declaration and the person's present condition is certified as terminal or a state of permanent unconsciousness by two physicians who personally examined the declarant, one of whom is the attending physician.

The chapter defines life-sustaining procedures as medical procedures or intervention that serve only to prolong the dying process when, in the attending physician's judgment, death will occur whether or not the procedures are used. It says life-sustaining procedures do not include medication or other treatment for comfort care or pain relief.

Section 44-77-40 gives signing and witness rules for the declaration. It calls for dating and signing in the presence of an officer authorized to administer oaths and two witnesses, with witness affidavit limits around family relationship, financial responsibility for medical care, estate interest, insurance beneficiary status, health facility employment, attending physician status, and estate claims.

How a Living Will Interacts With a Health Care POA

The statutory health care power of attorney form includes a section on the effect of a Declaration of Desire for Natural Death. It says that if the principal has a valid declaration, the declaration's instructions are given effect in any situation where they apply, and the agent has authority only in situations where the declaration does not apply.

That is why document coordination matters. A health care power of attorney can name the speaker for many medical decisions. A living will can give direct end-of-life instructions for the statutory conditions. A POST form can turn certain serious-illness treatment choices into physician orders.

Put all versions in one file so the care team does not receive conflicting copies.

Adult Health Care Consent Act Fallback

The Adult Health Care Consent Act applies when a patient is unable to consent. Section 44-66-20 defines unable to consent as being unable to appreciate the nature and implications of the patient's condition and proposed health care, make a reasoned decision, or communicate that decision clearly. It generally calls for certification by two licensed physicians, with an emergency exception for a health care professional responsible for care.

Section 44-66-30 gives a priority list for decisions when a patient is unable to consent. The list starts with a court-appointed guardian if the decision is within the guardianship scope, then an attorney-in-fact appointed in a durable power of attorney if the decision is within authority, then spouse, adult children, parent, adult siblings, grandparents, other close adult relatives, other statutory authority, and a person with an established relationship if higher-priority people are unavailable after good-faith efforts.

The statute also says efforts to locate a decision maker are recorded in the patient's medical record, and equal-priority disagreement can lead to a Probate Court petition.

For families, the fallback statute is not a substitute for a clear directive. It is a backstop when the care team needs decision authority and the patient's own signed directions or named agent are not enough to solve the immediate question.

POST Form Context

Title 44 Chapter 80 is the Physician Orders for Scope of Treatment Act. It defines advance care planning and advance directive. It defines a POST form as a physician order document for patients diagnosed with a serious illness or expected to lose capacity within twelve months, addressing key medical decisions consistent with goals of care.

The POST statute says an advance directive applies regardless of health status, while a POST form may be executed only by a patient diagnosed with a serious illness. In practice, that means a health care power of attorney and living will are planning documents many adults consider. A POST form is clinical and condition-specific.

Ask the treating physician or care team whether POST fits a current diagnosis. Keep the POST form with the medical record if it is used.

Revocation and Updates

Section 62-5-512 says a health care power of attorney may be revoked by a writing, oral statement, or other act notifying the agent or responsible health care provider of the principal's specific intent to revoke. It also can be revoked by a later health care power of attorney or a later durable power of attorney under Article 8 when the later document states an intent to revoke or is inconsistent with the health care power of attorney.

The same section says a health care provider informed of the revocation records it in the principal's medical record and notifies the agent, attending physician, and other responsible health care or nursing care providers.

Update the file after:

• agent death, divorce, separation, disability, refusal, or unavailability
• new diagnosis or care setting
• move to or from South Carolina
• new health system or physician
• change in religious, personal, or treatment values
• conflict between old and new copies
• signing a new financial POA or health care directive

Planning Checklist

Use this checklist while the principal can still decide and communicate:

1. Pick a health care agent and at least one successor agent.
2. Decide whether the health care POA, living will, and POST form all fit the situation.
3. Review treatment wishes, comfort care, nutrition, hydration, organ donation, burial or body-disposition notes, and personal statements.
4. Sign with the required witnesses and any required oath or affidavit language.
5. Give copies to the agent, successor agents, physician, hospital, care facility, and close family helper.
6. Keep a copy with the financial POA, will, trust, beneficiary records, and emergency contact list.
7. Ask the medical provider how the document appears in the patient portal or health system record.
8. Replace stale copies after revocation or update.

A South Carolina healthcare directive works best when the document, agent conversation, medical record, and family contact list all say the same thing.

Frequently Asked Questions

Is a South Carolina health care power of attorney the same as a financial POA?

No. A health care power of attorney handles medical decisions. A financial power of attorney handles money, property, insurance, tax, and transaction authority.

Does a South Carolina health care POA need two witnesses?

Yes. Section 62-5-503 requires at least two witnesses and includes witness eligibility limits. The statutory form repeats the two-witness requirement.

What is a South Carolina living will called?

South Carolina's living-will statute calls the document a Declaration of Desire for Natural Death. It applies to the statutory end-of-life conditions and signing rules in Title 44 Chapter 77.

Who makes decisions if there is no directive?

The Adult Health Care Consent Act gives a priority list when a patient is unable to consent. Depending on availability and scope, that list can include a guardian, attorney-in-fact, spouse, adult children, parent, adult siblings, grandparents, other relatives, and a person with an established relationship.

Is a POST form the same as an advance directive?

No. A POST form is a physician order set for certain serious-illness situations. A health care power of attorney or living will is an advance directive planning document.

Source Notes

• Title: South Carolina Probate Code Article 5, Part 5, Health Care Powers of Attorney. Publisher: South Carolina Legislature. Publication Date: Current official code page, accessed 2026-06-04. URL: https://www.scstatehouse.gov/code/t62c005.php
• Title: South Carolina Adult Health Care Consent Act, Title 44 Chapter 66. Publisher: South Carolina Legislature. Publication Date: Current official code page, accessed 2026-06-04. URL: https://www.scstatehouse.gov/code/t44c066.php
• Title: South Carolina Death With Dignity Act, Title 44 Chapter 77. Publisher: South Carolina Legislature. Publication Date: Current official code page, accessed 2026-06-04. URL: https://www.scstatehouse.gov/code/t44c077.php
• Title: South Carolina Physician Orders for Scope of Treatment Act, Title 44 Chapter 80. Publisher: South Carolina Legislature. Publication Date: Current official code page, accessed 2026-06-04. URL: https://www.scstatehouse.gov/code/t44c080.php
• Title: Legal Assistance for older adults. Publisher: South Carolina Department on Aging. Publication Date: Current agency page, accessed 2026-06-04. URL: https://aging.sc.gov/programs-initiatives/legal-assistance-seniors