North Carolina would let advance directives go online

When a medical crisis hits, the most important document in the room is often the one nobody is thinking about yet. In North Carolina, a bill would update the rules for health care powers of attorney and advance health care directives, the forms people use to say who should speak for them if they cannot make or communicate decisions themselves.

The change also gives residents a new way to file those papers with the secretary of state electronically. The practical effect is less about law-school language than about whether a family can keep a crucial form organized, accessible and ready when it matters.

The signature still has to count

The bill does not scrap the safeguards around these documents. A health care power of attorney would still have to be signed before two qualified witnesses or acknowledged before a notary public. The notary may, but does not have to be, a paid employee of a treating physician, a health facility, a nursing home or an adult care home.

The standard form also keeps an important reminder in plain view: there is no legal requirement that anyone execute a health care power of attorney. In other words, the state is making the paperwork easier to use, not forcing anyone into it.

A registry that can take an electronic file

The state would also broaden what can go into its advance health care directive registry. Under the bill, people could submit a health care power of attorney, a living will, an advance instruction for mental health treatment, a declaration of an anatomical gift or a HIPAA waiver in electronic or hard-copy form. Only the person who executed the document could submit it, and filings would still need notarization even when notarization was not otherwise required for validity.

The secretary of state would create a digital copy of paper filings and enter electronic filings directly into the registry. The office would assign each document a file number and password, but it would not be required to judge whether every document perfectly meets the separate legal requirements for validity.