General Assembly Passes End of Life Bill

Special Report - August 3, 2007

The North Carolina General Assembly has given final approval to a bill that revamps the state's laws regarding end of life care. House Bill 634—Advance Directives/Health Care Power of Attorney passed the Senate 34 to 10 on July 28 and the House 68 to 48 on July 30. The measure rewrites North Carolina’s health care power of attorney and living wills laws and also introduces an additional instrument—the Medical Order for Scope of Treatment (MOST) form—through which an individual may document their wishes regarding the level of care they desire to receive in an end of life situation.
Prior to passage, concerns were raised that the bill would create a state policy that allows individuals and physicians to end life before natural death occurs. The North Carolina Family Policy Council took issue with the fact that state law does not define a minimum level of care a patient is expected to receive in an end of life situation. While the legislation seems to be written in a way that presumes treatment will be provided, unless the patient elects to withhold or withdraw care through the use of one of these documents, the absence of a codified standard of care creates ambiguity in the law. The bill also fails to define a number of important terms and lacks a mechanism to ensure that a patient receives the treatment they desire in circumstances where the attending physician feels further care would be “futile.”
Lawmakers were initially considering a nearly identical version of the advance directives bill, SB 1026. This bill, however, was amended in the House Judiciary 1 Committee with a provision the bill sponsors opposed. In order to sidestep the amendment, the Senate Judiciary 2 Committee decided to replace the contents of an unrelated bill, HB 634, and replace it with the substance of SB 1046. The full Senate then passed HB 634 and the House concurred with the Senate version. The legislation now awaits the governor’s signature.

Copyright © 2007. North Carolina Family Policy Council. All rights reserved.